Quantification of Anti-GP50, Anti-rT24H, and Anti-sTs18var1 Antibodies to Identify Viable Infection in Patients with Neurocysticercosis

Identifying viable infections in neurocysticercosis (NCC) is crucial for treatment. Neuroimaging is the primary diagnostic tool, but it is not widely available. Moreover, in many cases, imaging diagnosis is not pathognomonic and requires serological confirmation. The serological assay of choice, enzyme-linked immunoelectrotransfer blot using lentil lectin-purified glycoprotein (LLGP-EITB) Taenia solium antigens to detect specific antibodies, exhibits high predictive values for the presence of viable NCC when the results are positive for multiple (>3) antibody bands; it also exhibits high predictive values for the absence of viable infection when the results are negative or the test reacts to a single antibody band. However, its interpretation in terms of viable infection is limited in cases with two or three positive bands (intermediate results), which occur in one-quarter of patients with NCC. The quantification of specific antibodies could allow for the identification of viable infections. Using a multi-antigen, quantitative multiplex bead assay, antibody levels were measured against Taenia solium proteins rGP50, rT24H, and sTs18var1 in 94 patients with intermediate LLGP-EITB results. The antibody-to-rT24H (25.96 versus 5.49; P = 0.0048) and antibody-to-sTs18var1 ratios (3.62 versus 1.37; P = 0.0083) were higher in subjects with viable cysticerci than in controls. Patients with high antibody levels against the proteins rT24H and sTs18var1 were 5.4 times more likely to have a viable infection than those with low antibody levels. The quantification of antibodies against rT24H and sTs18var1 can help define a viable NCC infection.