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Neopterin and CXCL-13 in Diagnosis and Follow-Up of Trypanosoma brucei gambiense Sleeping Sickness: Lessons from the Field in Angola
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Edité par CCSD ; Hindawi Publishing Corporation -
International audience. Human African Trypanosomiasis may become manageable in the next decade with fexinidazole. However, currently stagediagnosis remains difficult to implement in the field and requires a lumbar puncture. Our study of an Angolan cohort of T. b.gambiense-infected patients used other staging criteria than those recommended by the WHO. We compared WHO criteria (cellcount and parasite identification in the CSF) with two biomarkers (neopterin and CXCL-13) which have proven potential todiagnose disease stage or relapse. Biological, clinical, and neurological data were analysed from a cohort of 83 patients. A neopterinconcentration below 15.5 nmol/L in the CSF denoted patients with stage 1 disease, and a concentration above 60.31 nmol/Lcharacterized patients with advanced stage 2 (trypanosomes in CSF and/or cytorachia higher than 20 cells) disease. CXCL-13levels below 91.208 pg/mL denoted patients with stage 1 disease, and levels of CXCL-13 above 395.45 pg/mL denoted patients withadvanced stage 2 disease. Values between these cut-offs may represent patients with intermediate stage disease. Our work supportsthe existence of an intermediate stage in HAT, and CXCL-13 and neopterin levels may help to characterize it.
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