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Comparative evaluation of three commercial Toxoplasma-specific IgG antibody avidity tests and significance in different clinical settings

Branko Bobi, Ivana Klun, Marija Vujani, Aleksandra Nikoli, Vladimir Ivovi, Tijana ivkovi and Olgica Djurkovi-Djakovi

National Reference Laboratory for Toxoplasmosis, Serbian Centre for Parasitic Zoonoses, Institute for Medical Research, University of Belgrade, Belgrade, Serbia

Correspondence
Olgica Djurkovi-Djakovi
olgicadj{at}imi.bg.ac.yu

Received September 17, 2008
Accepted November 12, 2008

Determination of the avidity of specific IgG antibodies has become a generally accepted diagnostic aid for dating Toxoplasma infection. In this study, the Labsystems, VIDAS and EUROIMMUN Toxoplasma IgG avidity assays were compared on a series of 133 Toxoplasma IgG- and IgM-positive sera from symptomatic patients (n=28), from pregnant (n=43) and non-pregnant (n=26) women, and on 18 IgG-positive and IgM-negative sera from chronically infected patients. The results showed excellent concordance between the Labsystems and VIDAS tests in both the IgM-positive (r=0.82, =0.771) and IgM-negative (=0.609) sera, whilst the agreement of the EUROIMMUN assay with both the Labsystems and VIDAS tests in the IgM-positive sera was moderate (=0.575 and =0.525, respectively) and in the IgM-negative sera was poor (=0.000). Analysis of the kinetics of the maturation of avidity in 13 patients in whom follow-up sera were available showed that, despite a general trend of maturation, in two patients the avidity did not become high during 6 and 11 months of follow-up. In view of the clinical setting, in the symptomatic patients, despite one case of complete discrepancy and five cases of partial discrepancy, the Labsystems and VIDAS tests were in almost perfect agreement (=0.812), whilst the agreement in pregnant and non-pregnant women was substantial (=0.754 and =0.708, respectively). In conclusion, the Labsystems and VIDAS tests are equally reliable for the measurement of Toxoplasma IgG avidity; the choice of test should depend on the laboratory set-up. The EUROIMMUN test may be an acceptable alternative in resource-limited settings, but should be used prudently.