Serological diagnosis of chronic chagas disease: Is it time for a change?

Alba Abras, Montserrat Gállego, Teresa Llovet, Silvia Tebar, Mercedes Herrero, Pere Berenguer, Cristina Ballart, Carmen Martí, Carmen Muñoz

Research output: Contribution to journalArticleResearchpeer-review

30 Citations (Scopus)

Abstract

© 2016, American Society for Microbiology. All Rights Reserved. Chagas disease has spread to areas that are nonendemic for the disease with human migration. Since no single reference standard test is available, serological diagnosis of chronic Chagas disease requires at least two tests. New-generation techniques have significantly improved the accuracy of Chagas disease diagnosis by the use of a large mixture of recombinant antigens with different detection systems, such as chemiluminescence. The aim of the present study was to assess the overall accuracy of a newgeneration kit, the Architect Chagas (cutoff,>1 sample relative light units/cutoff value [S/CO]), as a single technique for the diagnosis of chronic Chagas disease. The Architect Chagas showed a sensitivity of 100% (95% confidence interval [CI], 99.5 to 100%) and a specificity of 97.6% (95% CI, 95.2 to 99.9%). Five out of six false-positive serum samples were a consequence of cross-reactivity with Leishmania spp., and all of them achieved results of <5 S/CO. We propose the Architect Chagas as a single technique for screening in blood banks and for routine diagnosis in clinical laboratories. Only gray-zone and positive sera with a result of≤6 S/CO would need to be confirmed by a second serological assay, thus avoiding false-positive sera and the problem of cross-reactivity with Leishmania species. The application of this proposal would result in important savings in the cost of Chagas disease diagnosis and therefore in the management and control of the disease.
Original languageEnglish
Pages (from-to)1566-1572
JournalJournal of Clinical Microbiology
Volume54
Issue number6
DOIs
Publication statusPublished - 1 Jun 2016

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