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Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis

BACKGROUND: There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection. METHODS: A systematic review of all cohort studies, which classified healthy leprosy contacts, at entr...

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Autores principales: Penna, Maria Lucia F., Penna, Gerson O., Iglesias, Paula C., Natal, Sonia, Rodrigues, Laura C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871561/
https://www.ncbi.nlm.nih.gov/pubmed/27192199
http://dx.doi.org/10.1371/journal.pntd.0004703
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author Penna, Maria Lucia F.
Penna, Gerson O.
Iglesias, Paula C.
Natal, Sonia
Rodrigues, Laura C.
author_facet Penna, Maria Lucia F.
Penna, Gerson O.
Iglesias, Paula C.
Natal, Sonia
Rodrigues, Laura C.
author_sort Penna, Maria Lucia F.
collection PubMed
description BACKGROUND: There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection. METHODS: A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value. RESULTS: Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%. CONCLUSIONS: Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.
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spelling pubmed-48715612016-05-31 Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis Penna, Maria Lucia F. Penna, Gerson O. Iglesias, Paula C. Natal, Sonia Rodrigues, Laura C. PLoS Negl Trop Dis Research Article BACKGROUND: There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection. METHODS: A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value. RESULTS: Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%. CONCLUSIONS: Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis. Public Library of Science 2016-05-18 /pmc/articles/PMC4871561/ /pubmed/27192199 http://dx.doi.org/10.1371/journal.pntd.0004703 Text en © 2016 Penna et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Penna, Maria Lucia F.
Penna, Gerson O.
Iglesias, Paula C.
Natal, Sonia
Rodrigues, Laura C.
Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title_full Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title_fullStr Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title_full_unstemmed Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title_short Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis
title_sort anti-pgl-1 positivity as a risk marker for the development of leprosy among contacts of leprosy cases: systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871561/
https://www.ncbi.nlm.nih.gov/pubmed/27192199
http://dx.doi.org/10.1371/journal.pntd.0004703
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