A CATT negative result after treatment for human African trypanosomiasis is no indication for cure.

Abstract

BACKGROUND:

Cure after treatment for human African trypanosomiasis (HAT) is assessed by examination of the cerebrospinal fluid every 6 months, for a total period of 2 years. So far, no markers for cure or treatment failure have been identified in blood. Trypanosome-specific antibodies are detectable in blood by the Card Agglutination Test for Trypanosomiasis (CATT). We studied the value of a normalising, negative post-treatment CATT result in treated Trypanosoma brucei (T.b.) gambiense sleeping sickness patients as a marker of cure.

METHODOLOGY/PRINCIPAL FINDINGS:

The CATT/T.b. gambiense was performed on serum of a cohort of 360 T.b. gambiense patients, consisting of 242 primary and 118 retreatment cases. The CATT results during 2 years of post-treatment follow-up were studied in function of cure or treatment failure. At inclusion, sensitivity of CATT was 98% (234/238) in primary cases and only 78% (91/117) in retreatment cases. After treatment, the CATT titre decreased both in cured patients and in patients experiencing treatment failure.

CONCLUSIONS/SIGNIFICANCE:

Though CATT is a good test to detect HAT in primary cases, a normalising or negative CATT result after treatment for HAT does not indicate cure, therefore CATT cannot be used to monitor treatment outcome.

• Authors: Veerle Lejon, Dieudonné Mumba Ngoyi, Marleen Boelaert, Philippe Büscher
• Journal: PLoS neglected tropical diseases (PLoS Negl Trop Dis) Vol. 4 Issue 1 Pg. e590 (Jan 26 2010) ISSN: 1935-2735 [Electronic] United States
• PMID: 20126270 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Protozoan
• Trypanocidal Agents
• Pentamidine
• Melarsoprol
• Eflornithine

Topics

• Agglutination Tests (methods)
• Antibodies, Protozoan (blood)
• Eflornithine (therapeutic use)
• Humans
• Melarsoprol (therapeutic use)
• Pentamidine (therapeutic use)
• Treatment Outcome
• Trypanocidal Agents (therapeutic use)
• Trypanosomiasis, African (drug therapy, immunology, parasitology)