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Successful Antiparasitic Treatment for Cysticercosis is Associated with a Fast and Marked Reduction of Circulating Antigen Levels in a Naturally Infected Pig Model

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  • School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Perú; Department of Microbiology, School of Sciences, Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú; Unidad de Bioinformática, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú; Instituto Peruano de Parasitología Clínica y Experimental, Lima, Perú; Department of Biomedical Sciences, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Taenia solium cysticercosis is a common parasitic infection of humans and pigs. We evaluated the posttreatment evolution of circulating parasite-specific antigen titers in 693 consecutive blood samples from 50 naturally infected cysticercotic pigs, which received different regimes of antiparasitic drugs (N = 39, 7 groups), prednisone (N = 5), or controls (N = 6). Samples were collected from baseline to week 10 after treatment, when pigs were euthanized and carefully dissected at necropsy. Antigen levels decreased proportionally to the efficacy of treatment and correlated with the remaining viable cysts at necropsy (Pearson's p = 0.67, P = 0.000). A decrease of 5 times in antigen levels (logarithmic scale) compared with baseline was found in 20/26 pigs free of cysts at necropsy, compared with 1/24 of those who had persisting viable cysts (odds ratio [OR] = 76.7, 95% confidence interval [CI] = 8.1–3308.6, P < 0.001). Antigen monitoring reflects the course of infection in the pig. If a similar correlation exists in infected humans, this assay may provide a minimally invasive and easy monitoring assay to assess disease evolution and efficacy of antiparasitic treatment in human neurocysticercosis.

Author Notes

* Address correspondence to Hector H. Garcia, Department of Microbiology, Universidad Peruana Cayetano Heredia, Avenue Honorio Delgado 430, SMP, Lima 31, Perú. E-mail: hgarcia@jhsph.edu

Financial support: Partial support from the Fogarty International Center/NIH (Training Grant no. TW001140), the Bill and Melinda Gates Foundation (Grant no. 23981), and NIH-1R01AI116456-01 is acknowledged. Hector H. Garcia is supported by a Wellcome Trust Senior Research Fellowship in Tropical Medicine and Public Health.

Authors' addresses: Armando E. Gonzalez, School of Veterinary Medicine, Lima, Peru, E-mail: agonza41@jhu.edu. Javier A. Bustos and Silvia Rodriguez, Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, and Instituto Peruano de Parasitología Clínica y Experimental, Lima, Peru, E-mails: javier.bustos@jhu.edu and silvia@peruresearch.org. Hector H. Garcia, Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Perú, and Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Perú, E-mail: hgarcia@jhsph.edu. Yesenia Castillo, Department of Microbiology, School of Sciences and Center for Global Health-Tumbes, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: yesicabe9@yahoo.es. Sarah Gabriël and Pierre Dorny, Department of Biomedical Sciences, Institute for Tropical Medicine, Antwerp, Belgium, E-mails: sgabriel@itg.be and pdorny@itg.be. Robert H. Gilman, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, E-mail: gilmanbob@gmail.com. Mirko Zimic, Unidad de Bioinformática, Laboratorios de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Perú, E-mail: mirko.zimic@upch.pe. Nicolas Praet, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium, E-mail: npraet@itg.be.

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