Subarachnoidal and intraventricular human neurocysticercosis:: application of an antigen detection assay for the diagnosis and follow-up

BACKGROUND Neurocysticercosis (NC) is a parasitic disease of the central nervous system caused by the larval stage of Taenia solium. Although imaging studies are recommended for diagnosis and follow-up of patients, their high cost and restricted availability limit their use. Among various immunological tests, the detection of HP10 antigen in cerebral spinal fluid (CSF) has proved to be a useful tool for the diagnosis of NC in the case of viable but not dead parasites. OBJECTIVES This study was designed to evaluate the usefulness of the detection of HP10 antigen for the diagnosis and follow-up of NC patients. METHODS The effectiveness of this HP10 assay was analysed for the CSF of 46 confirmed NC cases (21 men, 25 women) who had been clinically and radiologically described. RESULTS In 21 of 24 NC patients (87.5%) with viable parasites localized in the SA space at the base of the brain or in the ventricles these were detected by means of the HP10 assay, whilst none of the three patients with viable parasites in the parenchyma or sulci had these detected. Used for the follow-up of patients after cysticidal treatment, it was showed that levels of HP10 dropped significantly only among those patients whose cysticerci were clearly damaged. CONCLUSIONS HP10 antigen assay is recommended as a support for diagnosis and follow-up in NC patients with viable parasites localized in the SA space at the base of the brain or in the ventricles, thereby potentially reducing the number of imaging studies required.