دورية أكاديمية
Novel markers for treatment outcome in late-stage Trypanosoma brucei gambiense trypanosomiasis.
| العنوان: | Novel markers for treatment outcome in late-stage Trypanosoma brucei gambiense trypanosomiasis. |
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| المؤلفون: | Lejon V; Department of Parasitology, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerpen, Belgium. vlejon@itg.be, Roger I, Mumba Ngoyi D, Menten J, Robays J, N'siesi FX, Bisser S, Boelaert M, Büscher P |
| المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2008 Jul 01; Vol. 47 (1), pp. 15-22. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| مواضيع طبية MeSH: | Trypanosoma brucei gambiense/*isolation & purification , Trypanosomiasis, African/*drug therapy , Trypanosomiasis, African/*parasitology, Animals ; Antibodies, Protozoan/cerebrospinal fluid ; Biomarkers ; Cerebrospinal Fluid/chemistry ; Cerebrospinal Fluid/immunology ; Humans ; Immunoglobulin M/cerebrospinal fluid ; Interleukin-10/cerebrospinal fluid ; Leukocyte Count ; Melarsoprol/therapeutic use ; Predictive Value of Tests ; Proteins/analysis ; Treatment Outcome ; Trypanocidal Agents/therapeutic use |
| مستخلص: | Background: To date, no biological marker for treatment outcome in human African trypanosomiasis (HAT) has been described. The accuracy of biological markers for prediction of treatment outcome of HAT caused by Trypanosoma brucei gambiense was assessed. Methods: Cerebrospinal fluid (CSF) white blood cell (WBC) count and immunoglobulin M (IgM), trypanosome-specific antibody, total protein, and interleukin-10 levels were determined before and up to 24 months after treatment of late-stage HAT. Results: Treatment failure was experienced by 48 of 260 patients. Pretreatment CSF WBC counts > or = 102 cells/microL, IL-10 concentrations > or = 37 pg/mL, LATEX/IgM end titers > or = 1:32, LATEX/T. b. gambiense end titers > or = 1:2, and protein concentrations > or = 674 mg/L were associated with treatment failure. Six months after treatment, patients with CSF WBC counts < or = 5 cells/microL were at low risk of HAT recurrence (negative predictive value, >0.93). After 12 months, the combination of CSF WBC count > or = 8 cells/microL and LATEX/IgM end titer > or = 1:4 predicted treatment failure with 97% specificity and 79% sensitivity. Eighteen months after treatment, each marker accurately predicted treatment outcome. The combination of CSF WBC count > or = 8 cells/microL and LATEX/IgM end titer > or = 1:4 was 100% specific for treatment failure after 18 and 24 months. Conclusions: HAT-affected patients with elevated pretreatment CSF levels of WBC, interleukin-10, IgM, trypanosome-specific antibody, and total protein are at risk of treatment failure. Six months after treatment, patients with CSF WBC counts < or = 5 cells/microL can be considered to be cured. The assessment of a combination of CSF WBC count and LATEX/IgM level allowed accurate prediction of outcome beginning at 12 months after treatment, as did each individual marker at 18 months after treatment. |
| المشرفين على المادة: | 0 (Antibodies, Protozoan) 0 (Biomarkers) 0 (Immunoglobulin M) 0 (Proteins) 0 (Trypanocidal Agents) 130068-27-8 (Interleukin-10) ZF3786Q2E8 (Melarsoprol) |
| تواريخ الأحداث: | Date Created: 20080523 Date Completed: 20080703 Latest Revision: 20151119 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1086/588668 |
| PMID: | 18494605 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1537-6591 |
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| DOI: | 10.1086/588668 |