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VIDAS Test for Avidity of Toxoplasma-Specific Immunoglobulin G for Confirmatory Testing of Pregnant Women

Jose G. Montoya,^1,2* Oliver Liesenfeld,^1, Sandra Kinney,¹ Cynthia Press,¹ and Jack S. Remington^1,2

Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, Palo Alto,¹ Department of Medicine and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California²

Received 30 January 2002/ Returned for modification 3 April 2002/ Accepted 25 April 2002

Because congenital toxoplasmosis is almost solely the result of maternal infection acquired during gestation, it is critical to determine whether infection during pregnancy has occurred. In the United States, definitive diagnosis of the acute infection and the time of its occurrence have been compromised by a lack of systematic screening and the fact that only a single serum sample is submitted for testing. In studies in Europe, and depending on the method used, the demonstration of high-avidity immunoglobulin G (IgG) toxoplasma antibodies has been shown to exclude infection having occurred in the first 3 to 5 months of pregnancy. We investigated the usefulness of determining the avidity of IgG toxoplasma antibodies with a VIDAS kit (herein referred to as the VIDAS Toxo-IgG avidity kit, the VIDAS kit essentially rules out acute infection having occurred within the 4 prior months) in the setting of a reference serology laboratory in the United States. Sera (132 samples) from 132 women in the first 16 weeks of pregnancy were chosen because at least one test in the toxoplasma serological profile (TSP) suggested or was equivocal for a recently acquired infection. High-avidity antibodies were demonstrated in 75% of 99 sera positive with the IgM enzyme-linked immunosorbent assay (ELISA) and 31.3% of 16 sera with acute TSP results. A significant percentage of sera with equivocal results wtih the IgM ELISA or TSP also had high-avidity test results. Of 39 women for whom treatment with spiramycin had been suggested to attempt to prevent congenital transmission, 19 (48.7%) had high-avidity antibodies. These findings highlight the value of the VIDAS IgG avidity kit when used in combination with the TSP to exclude recent infection, especially when only a single serum sample is available.

Present address: Department of Medical Microbiology and Immunology of Infection, Institute for Infection Medicine, Benjamin Franklin Medical Center, Free University of Berlin, Berlin, Germany.

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