Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study
OBJECTIVE: The diagnosis of paucibacillary (PB) leprosy cases remains a challenge because of the absence of a confirmatory laboratory method. While quantitative polymerase chain reaction (qPCR) has been shown to provide reliable sensitivity and specificity in PB diagnoses, a thorough investigation o...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428338/ https://www.ncbi.nlm.nih.gov/pubmed/30835722 http://dx.doi.org/10.1371/journal.pntd.0007147 |
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author | Barbieri, Raquel R. Manta, Fernanda S. N. Moreira, Suelen J. M. Sales, Anna M. Nery, José A. C. Nascimento, Lilian P. R. Hacker, Mariana A. Pacheco, Antônio G. Machado, Alice M. Sarno, Euzenir M. Moraes, Milton O. |
author_facet | Barbieri, Raquel R. Manta, Fernanda S. N. Moreira, Suelen J. M. Sales, Anna M. Nery, José A. C. Nascimento, Lilian P. R. Hacker, Mariana A. Pacheco, Antônio G. Machado, Alice M. Sarno, Euzenir M. Moraes, Milton O. |
author_sort | Barbieri, Raquel R. |
collection | PubMed |
description | OBJECTIVE: The diagnosis of paucibacillary (PB) leprosy cases remains a challenge because of the absence of a confirmatory laboratory method. While quantitative polymerase chain reaction (qPCR) has been shown to provide reliable sensitivity and specificity in PB diagnoses, a thorough investigation of its efficacy in clinical practice has not yet been published. The present study evaluated patients with suspected leprosy skin lesions by using qPCR to identify PB individuals in the Leprosy Outpatient clinic at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. METHODS: One hundred seventy-two suspected PB cases were included in the study. The patients were evaluated by a dermatologist at three different times. The clinical dermato-neurological examination and collected samples were performed on the first visit. On the second visit, the results of the histopathological analysis and PCR assay (DNA-based Mycobacterium leprae qPCR-targeting 16S gene) results were analyzed, and a decision regarding multi-drug therapy was made. A year later, the patients were re-examined, and the consensus diagnosis was established. RESULTS: In 58% (100/172) of cases, a conclusive diagnosis via histopathological analysis was not possible; however, 30% (30/100) of these cases had a positive PCR. One hundred ten patients (110/172) attended the third visit. The analysis showed that while the sensitivity of the histopathological test was very low (35%), a qPCR alone was more effective for identifying leprosy, with 57% sensitivity. CONCLUSION: The use of qPCR in suspected PB cases with an inconclusive histology improved the sensitivity of leprosy diagnoses. |
format | Online Article Text |
id | pubmed-6428338 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64283382019-04-01 Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study Barbieri, Raquel R. Manta, Fernanda S. N. Moreira, Suelen J. M. Sales, Anna M. Nery, José A. C. Nascimento, Lilian P. R. Hacker, Mariana A. Pacheco, Antônio G. Machado, Alice M. Sarno, Euzenir M. Moraes, Milton O. PLoS Negl Trop Dis Research Article OBJECTIVE: The diagnosis of paucibacillary (PB) leprosy cases remains a challenge because of the absence of a confirmatory laboratory method. While quantitative polymerase chain reaction (qPCR) has been shown to provide reliable sensitivity and specificity in PB diagnoses, a thorough investigation of its efficacy in clinical practice has not yet been published. The present study evaluated patients with suspected leprosy skin lesions by using qPCR to identify PB individuals in the Leprosy Outpatient clinic at the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. METHODS: One hundred seventy-two suspected PB cases were included in the study. The patients were evaluated by a dermatologist at three different times. The clinical dermato-neurological examination and collected samples were performed on the first visit. On the second visit, the results of the histopathological analysis and PCR assay (DNA-based Mycobacterium leprae qPCR-targeting 16S gene) results were analyzed, and a decision regarding multi-drug therapy was made. A year later, the patients were re-examined, and the consensus diagnosis was established. RESULTS: In 58% (100/172) of cases, a conclusive diagnosis via histopathological analysis was not possible; however, 30% (30/100) of these cases had a positive PCR. One hundred ten patients (110/172) attended the third visit. The analysis showed that while the sensitivity of the histopathological test was very low (35%), a qPCR alone was more effective for identifying leprosy, with 57% sensitivity. CONCLUSION: The use of qPCR in suspected PB cases with an inconclusive histology improved the sensitivity of leprosy diagnoses. Public Library of Science 2019-03-05 /pmc/articles/PMC6428338/ /pubmed/30835722 http://dx.doi.org/10.1371/journal.pntd.0007147 Text en © 2019 Barbieri 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 Barbieri, Raquel R. Manta, Fernanda S. N. Moreira, Suelen J. M. Sales, Anna M. Nery, José A. C. Nascimento, Lilian P. R. Hacker, Mariana A. Pacheco, Antônio G. Machado, Alice M. Sarno, Euzenir M. Moraes, Milton O. Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title | Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title_full | Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title_fullStr | Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title_full_unstemmed | Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title_short | Quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: A follow-up study |
title_sort | quantitative polymerase chain reaction in paucibacillary leprosy diagnosis: a follow-up study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428338/ https://www.ncbi.nlm.nih.gov/pubmed/30835722 http://dx.doi.org/10.1371/journal.pntd.0007147 |
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