Advertisement

Interpretation of very low avidity indices acquired with the Liaison XL Toxo IgG avidity assay in dating toxoplasmosis infection

  • Frédérique Boquel
  • Lorra Monpierre
  • Sébastien Imbert
  • Feriel Touafek
  • Régis Courtin
  • Renaud Piarroux
  • Luc ParisEmail author
Original Article
  • 75 Downloads

Abstract

Congenital toxoplasmosis is an important cause of complications in pregnancy. Toxoplasmosis is often asymptomatic and thus serological tests are usually performed to screen for it. A first serum which exhibit both IgG and IgM may be due to nascent toxoplasmosis seroconversion, non-specific IgM reaction, or residual IgM. The IgG avidity test has been proposed to identify latent infections. A high index excludes recent toxoplasmosis whereas an intermediate or low index only suggests a recent infection, the caveats being that some people with latent Toxoplasma gondii infection show IgG with low or intermediate avidity. In this study, we investigated the ability of the Liaison XL Toxo IgG avidity (DiaSorin, Saluggia, Italy) assay to confirm recent infection when IgG avidity index is very low (≤ 0.1). Four thousand two hundred ninety-seven sera exhibiting both IgG and IgM were included and avidity was performed on the Liaison device according to the manufacturer’s recommendations. One hundred twenty-six sera on the 297 sera which exhibited very low IgG avidity indices (≤ 0.1) could be exploited: 97% of sera with IgG avidity indices < 0.05 actually corresponded to recent infection (less than 3 months). A similar but less pronounced trend was observed for the sera exhibiting indices between 0.05 and 0.1 (69% corresponded to recent infections). The IgG avidity index data we obtained with the Liaison XL Toxo device are similar to those obtained with other devices. This body of consistent results underlines the interest of very low IgG avidity indices as a sign of probable recent toxoplasmosis.

Keywords

Congenital toxoplasmosis Recent infection Low IgG index avidity 

References

  1. 1.
    Robert-Gangneux F, Darde M-L (2012) Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev 25(2):264–296CrossRefGoogle Scholar
  2. 2.
    Yera H, Paris L, Bastien P, Candolfi E (2015) Diagnostic biologique de la toxoplasmose congénitale. Rev Fr Lab 2015(470):65–72Google Scholar
  3. 3.
    Fricker-Hidalgo H, L’Ollivier C, Bosson C, Imbert S, Bailly S, Dard C et al (2017) Interpretation of the Elecsys Toxo IgG avidity results for very low and very high index: study on 741 sera with a determined date of toxoplasmosis. Eur J Clin Microbiol Infect Dis 36(5):847–852CrossRefGoogle Scholar
  4. 4.
    Dardé M-L, Peyron F (2012) Toxoplasme et toxoplasmose. EMC - Pédiatrie - Maladies infectieuses 7(4):1–12CrossRefGoogle Scholar
  5. 5.
    Gras L, Gilbert RE, Wallon M, Peyron F, Cortina-Borja M (2004) Duration of the IgM response in women acquiring Toxoplasma gondii during pregnancy: implications for clinical practice and cross-sectional incidence studies. Epidemiol Infect 132(3):541–548CrossRefGoogle Scholar
  6. 6.
    Villard O, Breit L, Cimon B, Franck J, Fricker-Hidalgo H, Godineau N et al (2013) Comparison of four commercially available avidity tests for Toxoplasma gondii-specific IgG antibodies. Clin Vaccine Immunol 20(2):197–204CrossRefGoogle Scholar
  7. 7.
    Lachaud L, Calas O, Picot MC, Albaba S, Bourgeois N, Pratlong F (2009) Value of 2 IgG avidity commercial tests used alone or in association to date toxoplasmosis contamination. Diagn Microbiol Infect Dis 64(3):267–274CrossRefGoogle Scholar
  8. 8.
    Flori P, Chene G, Varlet MN, Sung RT (2009) Toxoplasma gondii serology in pregnant woman: characteristics and pitfalls. Ann Biol Clin 125–133Google Scholar
  9. 9.
    Hedman K, Lappalainen M, Seppaia I, Makela O (1989) Recent primary toxoplasma infection indicated by a low avidity of specific IgG. J Infect Dis 159(4):736–740CrossRefGoogle Scholar
  10. 10.
    Soula F, Fréalle E, Durand-Joly I, Dutoit E, Rouland V, Renard E et al (2007) Intérêt de l’indice d’avidité des IgG pour le diagnostic d’exclusion d’une toxoplasmose récente: comparaison de la trousse Toxo IgG Avidité SFRI® à la trousse Toxo IgG Avidity Vidas®. Ann Biol Clin 257–264Google Scholar
  11. 11.
    Peyron F, Mc Leod R, Ajzenberg D, Contopoulos-Ioannidis D, Kieffer F, Mandelbrot L et al (2017) Congenital toxoplasmosis in France and the United States: one parasite, two diverging approaches. Torgerson PR, éditeur. PLOS Negl Trop Dis 11(2):e0005222Google Scholar
  12. 12.
    Sickinger E, Gay-Andrieu F, Jonas G, Schultess J, Stieler M, Smith D et al (2008) Performance characteristics of the new ARCHITECT Toxo IgG and Toxo IgG avidity assays. Diagn Microbiol Infect Dis 62(3):235–244CrossRefGoogle Scholar
  13. 13.
    Jost C, Touafek F, Fekkar A, Courtin R, Ribeiro M, Mazier D et al (2011) Utility of immunoblotting for early diagnosis of toxoplasmosis seroconversion in pregnant women. Clin Vaccine Immunol 18(11):1908–1912CrossRefGoogle Scholar
  14. 14.
    Peyron F, Wallon M, Kieffer F, Garweg J (2016) Toxoplasmosis. In: Infectious Diseases of the Fetus and the Newborn Infant, pp 949–1042Google Scholar
  15. 15.
    Murat J-B, L’Ollivier C, Fricker Hidalgo H, Franck J, Pelloux H, Piarroux R (2012) Evaluation of the new Elecsys Toxo IgG avidity assay for toxoplasmosis and new insights into the interpretation of avidity results. Clin Vaccine Immunol 19(11):1838–1843CrossRefGoogle Scholar
  16. 16.
    Petersen E, Borobio MV, Guy E, Liesenfeld O, Meroni V, Naessens A et al (2005) European multicenter study of the LIAISON automated diagnostic system for determination of toxoplasma gondii-specific immunoglobulin G (IgG) and IgM and the IgG avidity index. J Clin Microbiol 43(4):1570–1574CrossRefGoogle Scholar
  17. 17.
    Candolfi E, Pastor R, Huber R, Filisetti D, Villard O (2007) IgG avidity assay firms up the diagnosis of acute toxoplasmosis on the first serum sample in immunocompetent pregnant women. Diagn Microbiol Infect Dis 58(1):83–88CrossRefGoogle Scholar
  18. 18.
    Wallon M, Peyron F, Cornu C, Vinault S, Abrahamowicz M, Kopp CB et al (2013) Congenital toxoplasma infection: monthly prenatal screening decreases transmission rate and improves clinical outcome at age 3 years. Clin Infect Dis 56(9):1223–1231CrossRefGoogle Scholar
  19. 19.
    Mandelbrot L, Kieffer F, Sitta R, Laurichesse-Delmas H, Winer N, Mesnard L et al (2018) Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol 219(4):386.e1–386.e9.  https://doi.org/10.1016/j.ajog.2018.05.031 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Service de Parasitologie-MycologieAP-HP, Hôpitaux Universitaires Pitié-Salpêtrière/Charles FoixParis Cedex 13France
  2. 2.Centre d’Immunologie et des Maladies Infectieuses, CIMI-ParisParisFrance
  3. 3.AP-HP, Hôpital Pitié-SalpêtrièreSorbonne UniversitéParisFrance
  4. 4.Institut Pierre-Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-SalpêtrièreSorbonne Université, INSERMParisFrance

Personalised recommendations