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Journal of Clinical Microbiology, June 2005, p. 2764-2770, Vol. 43, No. 6
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.6.2764-2770.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Comparative Analysis of the Diagnostic Performance of Six Major Echinococcus granulosus Antigens Assessed in a Double-Blind, Randomized Multicenter Study

Carmen Lorenzo,¹ Henrique B. Ferreira,² Karina M. Monteiro,² Mara Rosenzvit,³ Laura Kamenetzky,³ Hector H. García,⁴ Yessika Vasquez,⁴ Cesar Naquira,⁵ Elizabeth Sánchez,⁵ Myriam Lorca,⁶ María Contreras,⁶ Jerry A. Last,⁷ and Gualberto G. González-Sapienza^1*

Cátedra de Inmunología, Facultad de Química, UDELAR, Instituto de Higiene, Montevideo, Uruguay,¹ Laboratório de Biologia Molecular de Cestódeos, Centro de Biotecnología, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil,² Departamento de Parasitología, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán," Buenos Aires, Argentina,³ Departamento de Microbiología, Universidad Peruana Cayetano Heredia, Instituto de Ciencias Neurológicas, Lima, Peru,⁴ Laboratorio de Zoonosis, División de Parasitología, Instituto Nacional de Salud, Lima, Peru,⁵ Unidad de Parasitología, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile,⁶ Department of Internal Medicine (Pulmonary), School of Medicine, University of California, Davis, California⁷

Received 11 November 2004/ Returned for modification 7 January 2005/ Accepted 10 February 2005

The serodiagnosis of hydatid disease is a valuable instrument for clinical diagnosis and epidemiological surveillance of high-risk populations. In the past decade a wealth of reports on the diagnostic performance of numerous antigens have been produced. However, their diagnostic value has been estimated under different conditions, using different serum collection, therefore precluding their direct comparison. Here we report an unbiased comparison of the same batch of six major E. granulosus antigens, namely, hydatid cyst fluid (HCF), native antigen B (AgB), two recombinant AgB subunits, an AgB-derived synthetic peptide, and recombinant cytosolic malate dehydrogenase from E. granulosus (EgMDH), against the same serum collection. The double-blind analysis was performed using a standardized protocol and receiver operating characteristic (ROC) data analysis by a network of six South American laboratories. High intercenter reproducibility was attained, and the intralaboratory analysis allowed the comparative ranking of the antigen panel. HCF, AgB, and its AgB8/1 subunit exhibited equivalent diagnostic efficiencies, 81.4% ± 0.5%, 81.3% ± 0.6%, and 81.9% ± 2.0%, respectively; with a more favorable balance toward specificity in the case of the last antigen. The diagnostic efficiencies for the other three antigens were 76.8% ± 6.8%, 69.1% ± 2.7%, and 66.8% ± 2.1%, for the peptide, the AgB8/2 subunit, and the EgMDH, respectively. The study also included an analysis of batch-to-batch variation in the diagnostic performance of different HCF regional preparations. Based on these results, a suggested recommendation on the use of these antigens was drawn.

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* Corresponding author. Mailing address: Cátedra de Inmunología, AV. A. Navarro 3051, 11600 Montevideo, Uruguay. Phone: (5982) 4874334. Fax: (5982) 4874320. E-mail: ggonzal{at}fq.edu.uy.

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Journal of Clinical Microbiology, June 2005, p. 2764-2770, Vol. 43, No. 6
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.6.2764-2770.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

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