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Master's Dissertation
DOI
https://doi.org/10.11606/D.9.1999.tde-04102006-235758
Document
Author
Full name
Maria Luiza Bazzo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 1999
Supervisor
Committee
Yamamoto, Yoshimi Imoto (President)
Alchorne, Mauricio Motta de Avelar
Shimizu, Sumie Hoshino
Title in Portuguese
Avaliação do uso de teste treponêmico imunoenzimático competitivo na triagem sorológica da sífilis em 23.531 soros de uma população de baixa prevalência
Keywords in Portuguese
Sífilis
Sorologia
Teste Imunoenzimático
teste não treponêmico
teste treponêmico de imunofluorescência indireta
Western blot
Abstract in Portuguese
Foram testadas, com o teste não treponêmico VDRL e com o teste treponêmico imunoenzimático de competição, 23.531 amostras de soros, coletados em todas as regiões do Brasil, com o objetivo de verificar o comportamento do teste imunoenzimático treponêmico na triagem de amostras. A prevalência obtida foi de 0,63% com o VDRL e de 0,84% para o teste imunoenzimático. A análise dos dados foi feita comparando-se os resultados dos dois testes com os resultados do teste treponêmico de imunofluorescência indireta (FTA-ABS), considerado como teste de referência. No total, 1120 amostras foram submetidas ao teste FTA-ABS, incluindo todas as que foram reagentes em qualquer um dos testes de triagem e 872 amostras negativas. Amostras com resultados discordantes entre os testes foram submetidas a um teste imunoenzimático do tipo Western blot. Nas amostras por nós estudadas, o teste imunoenzimático apresentou sensibilidade de 89,95% e especificidade de 99,78%, muito superior aos 55,11% de sensibilidade e 97,43% de especificidade que encontramos para o VDRL. Os resultados dos testes detectaram positividade em amostras diferentes portanto, recomendamos utilizar a associação dos dois testes, como método de triagem, quando se trata de populações de baixa prevalência. Resultados preliminares do Western blot sugerem a participação doas proteínas de 43 kD, 17 kD e 15,5 kD na reação de ELISA treponêmico competitivo.
Title in English
Assessment of a Treponemal Competitive Enzyme Immunoassay for Syphilis Antibody Screening in 23,531 Serum Samples from a Low Prevalence Population.
Keywords in English
fluorescent treponemal autibody absorption test
Immunoassay
non treponemal test
Serology
Syphilis
Western blot
Abstract in English
The VDRL, a non treponemal test, and a treponemal competitive ELISA were used to test 23,531 serum samples, collected from conscript men throughout Brazil, with the objective of assessing the performance of the competitive ELISA on the screening of serum samples. The VDRL showed a prevalence of 0.63% contrasting with a 0.84% prevalence showed by the competitive ELISA. The results obtained with the two tests were then compared to those obtained by fluorescent treponemal antibody absorption (FTA-ABS) test which is considered the gold standard method for detection of antibodies for syphilis. A total number of 1,120 samples, which included all that were reagent in at least one of the screening test plus 872 that were negative in both tests, were submitted to the FTA_ABS test. In addition, some of the samples that presented discrepant results between the two tests studied were also submitted to the Western blot test. The results of the screening tests showed an 89.95% sensitivity and a 99.78% specificity for the competitive ELISA, which are much higher than the 55.11% sensitivity and 97.43% specificity presented by the VDRL. Also, the tests detected positivity in different samples. In conclusion, we recommended the use in tandem of both tests as screening for syphilis antibodies in low prevalence populations. In addition, the results of the Western blot seemed to suggest the positivity of the ELISA becoming non reactive after treatment of the patient and that the 43 kD, 17 kD and 15 kD proteins are the main proteins involved in the ELISA competitive reaction.
 
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Publishing Date
2006-12-08
 
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