Detection of HP10 antigen in serum for diagnosis and followup of subarachnoidal and intraventricular human neurocysticercosis

Introduction: Neurocysticercosis ( NC), a parasitic disease caused by Taenia solium, may be either asymptomatic or show a mild to severe clinical picture with intracranial hypertension. The most severe form of the disease is caused when viable cysticerci are localised in the ventricles or in subarachnoidal cisterns at the base of the skull. Detection of the secreted metacestode antigen HP10 in cerebrospinal fluid is a sensitive and specific method for the diagnosis of these severe NC cases. Objective and methods: To evaluate the validity of HP10 antigen detection ELISA when applied to serum, using paired serum and cerebrospinal fluid samples from 116 radiologically and clinically characterised NC patients. Results: The HP10 antigen assay exhibited a similarly high sensitivity in identifying severe NC cases from sera ( 84.8%) and CSF ( 91.3%). In contrast, HP10 antigen was rarely detected in asymptomatic or mild NC cases ( 3 of 57). Importantly, the HP10 antigen assay applied to serum showed high specificity ( 94%) when used in 126 serum samples of non- NC subjects from an endemic community with a confirmed coproparasitological diagnosis of intestinal parasitic infections. Finally, the HP10 assay also proved to be of value in the follow- up of treated patients. Conclusion: This study confirms that detection of the metacestode HP10 antigen in serum is a useful tool for diagnosis and follow- up of patients with severe forms of NC treated with cysticidal drugs.