RESUMO
IgM antibody levels against PGL-1 antigen were measured by M. leprae particle agglutination (MLPA) in 156 untreated leprosy patients. The seropositivity rate was much higher in newly untreated MB patients (84.7%) than in PB patients (19.7%). The mean MLPA titers in MB and PB declined significantly after 1 month of MDT (p < 0.001). Seropositivities in control serum specimens were 11.3 per cent in active pulmonary tuberculosis patients, 2.6 per cent in dermatologic patients and 4.4 per cent in a healthy population, in low titers. The study confirms that, anti PGL-1 assay using MLPA is a sensitive and specific diagnostic tool for the diagnosis of leprosy especially MB patients. Additionally, it provides an alternative tool in monitoring leprosy patients under MDT.
Assuntos
Anticorpos Antibacterianos/sangue , Hanseníase/diagnóstico , Mycobacterium leprae/imunologia , Adolescente , Adulto , Idoso , Testes de Aglutinação/métodos , Testes de Aglutinação/estatística & dados numéricos , Análise de Variância , Antígenos de Bactérias/imunologia , Criança , Pré-Escolar , Monitoramento de Medicamentos/métodos , Monitoramento de Medicamentos/estatística & dados numéricos , Feminino , Glicolipídeos/imunologia , Humanos , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeAssuntos
Adolescente , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Análise de Variância , Criança , Glicolipídeos/imunologia , Hansenostáticos/uso terapêutico , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Monitoramento de Medicamentos/estatística & dados numéricos , Monitoramento de Medicamentos/métodos , Mycobacterium leprae/imunologia , Pré-Escolar , Sensibilidade e Especificidade , Testes de Aglutinação/estatística & dados numéricos , Testes de Aglutinação/métodosRESUMO
A comparative assessment of three serological methods for leprosy diagnosis (the fluorescent leprosy antibody absorption [FLA-ABS] test, the Mycobacterium leprae soluble-extract enzyme-linked immunosorbent assay [ELISA], and the M. leprae particle agglutination [MLPA] test) was carried out. The objective was to identify their performance in clinical and epidemiological diagnosis of leprosy. The study group included 45 lepromatous leprosy patients under treatment. Specificity was > 95% for all three assays, and sensitivity was 95, 58, and 74% for the FLA-ABS test, the MLPA test, and the ELISA, respectively. The only cross-reactivity for M. tuberculosis-infected patients was with the soluble-extract ELISA. Although the FLA-ABS test displayed the highest specificity and sensitivity values, it can only be used in well-developed laboratories, and the patient's clinical and epidemiological background must be considered when results are interpreted because the test remains positive after therapeutic success and could be positive for some household contacts. The MLPA test is easier to perform and interpret, and it is adequate for small laboratories and epidemiological studies intended to detect active untreated or irregularly treated leprosy cases. Therefore, the FLA-ABS and MLPA tests are complementary, and both should be used for serodiagnosis of leprosy.