Serological monitoring for Echinococcus multilocularis

Description test

For monitoring alveolar echinococcosis, a combination of two ELISA tests targeting anti-Em2/rEm18 IgG and anti-rEm18 IgG respectively is used.

Goal test

The combination of the two ELISA tests makes it possible to monitor the decrease in the titer of antibodies, which are indicators of parasite activity, in patients with alveolar echinococcosis undergoing treatment with benzimidazoles. The purpose of this follow-up is therefore either to evaluate the efficacý of the treatment in order to detect a possible revival of the infection or to follow a patient whose lesions are a priori calcified and without parasitic metabolic activity.

Criteria

1. IgG anti-E. multilocularis Em2/rEm18 ELISA + IgG anti-E. multilocularis rEm18 ELISA
   This combination of tests is used to monitor patients with alveolar echinococcosis undergoing treatment with benzimidazoles.  It is performed every 3 months during the first year of treatment, then at 6 and 12 months during the second year. At present, there are no published guidelines on the follow-up of alveolar echinococcosis other than a recommendation for testing at two years post-treatment after surgery according to Wen H. et al (2019).
    
2. Western Blot
   The western blot is carried out 2 years after the start of drug treatment to assess the disappearance of antibodies detected by this method.. 

Instructions regarding the sample

• Sample type: serum
• Conditions for storage: conservation at 2-8°C
• Required quantity: minimum 3-5 mL

Instructions for transportation

• It is recommended that the serum be transported at a temperature of between 2 and 8°C. 
• Labeling and conditions complying with the rules concerning infectious samples, containers, and packaging are applicable.

Demandes that cannot be accepted

If the request form is missing or if it’s incomplete.

Timeframe for receiving test results (and frequency of analysis)

• Tests are carried out once a week. Results are available the same day or a week later if control is required. 
• The “turnaround time” (TAT) for this type of analysis is 3 weeks.

Communication of the results

The results are communicated via a report sent by post or electronically. Positive results are communicated by telephone and faxed to the clinician.