Seroprevalence of babesiosis in immunocompetent and immunocompromised individuals.

Interest in Babesia species is gaining an increasing attention as an emerging tick-borne pathogen. Infection is primarily transmitted through Ixodes ticks, and alternatively by blood transfusions from asymptomatic donors. AIM: The aim of the study was detection of Babesia seroprevalence in different groups of population with the usage of experimental B. divergens whole-cell slide antigen and commercial B. microti immunofluorescence assay substrate slide. MATERIALS AND METHODS: Indirect immunofluorescence assay trial was performed by testing of 145 blood samples of different origins: healthy individuals (60 - blood donors), risk groups (30 - HIV-infected individuals, 30 - Lyme disease patients) and false-positive IFA controls (10 - seropositive rheumatoid arthritis patients, 15 - patients with toxoplasmosis). RESULTS: The study revealed Babesia antibodies to B. divergens (6.9%) and B. microti (3.4%) that were detected with higher (p <0.05) frequency in HIV-infected individuals (26.7%) and in Lyme disease patients (16.7%) than at blood donors (1.7%). Diagnostically significant IgG titres were detected at 23.3% HIV-infected individuals, 13.3% Lyme disease patients and by 1.7% of blood donors and patients with seropositive latent toxoplasmosis. Specific IgM were detected at 20.0% HIV-infected individuals and 13.3% Lyme disease patients. 57.1% of diagnostically significant titres in HIV-infected and Lyme disease patients were represented by IgG and IgM. CONCLUSIONS: Immunofluorescence assay has a limited use in babesiosis: in acute form with negative microscopy or PCR; in chronic, asymptomatic and subclinical form with low level of parasitemia; and in retrospective and epidemiological studies of the population immune structure. Clinicians need to have increased awareness of babesiosis, and further studies are needed to clarify the optimal management of this infection in risk groups (including HIV-infected patients and blood donors).

Implementation and analysis of Babesia immunoassay testing.

Lifelong withdrawal from the donor population of those who have been diagnosed with babesiosis must be used for transmission prevention. AIM: The aim of the study was a detection of Babesia antibodies level with the usage of experimental Babesia divergens whole-cell slide antigen and commercial B. microti immunofluorescence assay substrate slide (Fuller Laboratories, USA). MATERIALS AND METHODS: Experimental B. divergens whole-cell slide antigen in addition to commercial B. microti IFA substrate slide was used to create a diagnostic kit for serum Babesia antibodies level detecting, as well as for a babesiosis serodiagnosis clinical trial of different origins blood samples (patients with Lyme disease, rheumatoid arthritis and toxoplasmosis; human blood donors; cattle). RESULTS: Antibodies to B. divergens (5.4%) and B. microti (2.3%) were detected with higher (p <0.05) frequency at Lyme disease patients (16.7%) than at blood donors (1.7%). Diagnostically significant IgG titres (= 1:128) were found in 13.3% of blood samples from Lyme disease patients and 1.7% from blood donors. Specific IgM were also found in 13.3% blood samples from Lyme disease patients. Among blood samples from Lyme disease patients, in which diagnostically significant titres of Babesia antibodies were detected (16.7%), 60% of them were represented by IgG and IgM (rA= 0.63), and in 40% only one of them reached diagnostically significant titre. Conclusions. Advantages of babesiosis IFA diagnostics. CONCLUSIONS: Advantages of babesiosis IFA diagnostics are combined with its significant disadvantages (principle of evaluation, low sensitivity in the initial period of the disease, probability of false positives, absence of validated test systems and research protocols for B. divergens and B. divergens-like species).

Immunodiagnostics of cerebral toxoplasmosis depending on permeability of blood-brain barrier.

OBJECTIVE: The aim of the work was to detect a diagnostic value of CNSToxoIndex - index of correlation between albumin concentration and anti-toxoplasma antibodies, which reflects local production of anti-toxoplasma IgG in CNS compared with their level in blood. PATIENTS AND METHODS: Materials and methods: 30 HIV-infected persons with the IV clinical stage (16 man and 14 women) aged from 25 to 49 years with clinical and instrumental signs of cerebral toxoplasmosis were selected from the general array of the patients treated in the Regional Clinical Infectious Hospital. A retrospective parallel detection of IgG T. gondii was performed in serum and CSF in patients, whose results of ELISA or PCR on T. gondii were positive. Blood serum and CSF were obtained from patients at the same time. All samples for analysis were stored at -20 °C and then tested on the RT-2100C Rayto Life and Analytical Sciences Co., Ltd (China) immunoassay analyser for quantitative detection of the level of specific anti-Toxicoplasma IgG. Detection of albumin concentration in serum and CSF was performed on the Chemray-120 Automated Biochemical Analyzer Rayto Life and Analytical Sciences Co., Ltd (China) using the Liquick Cor-ALBUMIN Diagnostic Kit. RESULTS: Results: Specific IgG to T. gondii in blood plasma was found in 27 patients (90%) while in CSF only in 7 (23 %). The results of the research in this group of patients were represented by the following parameters: patient 1 (blood antiToxo IgG - 200 IU/ml, blood albumin - 36 g/l, CSF antiToxo IgG - 10 IU/ml, CSF albumin - 0.8 g/l, CNSToxolndex - 2.3); patient 2 (150 / 40 / 90 / 0.7 / 34.3, respectively); patient 3 (90 / 35 / 64 / 0.25 / 99.6); patient 4 (140 / 39/ 10/ 0.19/ 14.7); patient 5 (88 / 52 / 48 / 0.21 / 135.1); patient 6 (160 / 48 / 50 /0.15 / 100.0); patient 7 (122 / 42 / 15 / 0.17 / 30.4). Consequently, taking into consideration the diagnostic marker CNSToxolndex more than 10.0, cerebral toxoplasmosis was diagnosed only in six patients from seven, in whom anti-toxoplasma antibodies in CSF were detected. Patient 1, despite clinical symptoms similar to cerebral toxoplasmosis, and substitute signs of cerebral toxoplasmosis detected with the help of neuroimaging methods (volumetric formation of the right frontal lobe with a ring-shaped enhancement), availability of specific anti-toxoplasma antibodies in blood serum and CSF, diagnosis of cerebral toxoplasmosis has not been confirmed. M. tuberculosis DNA was found in CSF by PCR. CONCLUSION: Conclusions: CNSToxoIndex allows evaluating the local production of anti-toxoplasmic IgG in CNS and their diffusion from blood as a result of the blood-brain barrier damageand it is a powerful method of cerebral toxoplasmosis diagnostics in HIV-positive people as well.

Pathomorphological peculiarities of tuberculous meningoencephalitis associated with HIV infection.

BACKGROUND AND AIMS: One of the most severe manifestation displays of tuberculosis (TB) generalization is meningitis/meningoencephalitis. The purpose of this work was to improve the diagnostic efficiency of TB central nervous system (CNS) affection in human immunodeficiency virus (HIV)-infected persons. MATERIALS AND METHODS: Meninges and cerebral tissues, taken from died patients, who were HIV-infected and dead from TB of CNS affection, were investigated histologically. RESULTS AND DISCUSSION: Our examination showed that clinical course of the pathologic process loses the peculiarity of TB-undulating character, and changes in tissues have monomorphism that appears in the presence of the same type of granulomas with a few Pirogov-Langhans cells. Alterative reactions with formation of the large fields of caseous necrosis, necrotic focuses, areas of infiltration with polymorphic cellular elements went out on the first plan in the disorder of cerebrum in patients with the terminal stage of HIV infection. The tendency to decrease in inflammatory-proliferative processes was observed, which is confirmed by the presence of the poorly expressed cellular reaction on the peripheries of focuses of caseous necrosis. CONCLUSION: Morphologic features of tuberculous meningoencephalitis in HIV-infected patients are the presence of edema, gliosis, trombovasculitis, small focal hemorrhage, tuberculous granuloma formation with a small number of Pirogov-Langhans cells, and the prevalence of alterative-exudative reactions.