Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/29682
Type
ArticleCopyright
Open access
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
Metadata
Show full item record
HIGHLY ACCURATE CHIMERIC PROTEINS FOR THE SEROLOGICAL DIAGNOSIS OF CHRONIC CHAGAS DISEASE: A LATENT CLASS ANALYSIS
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Fio-Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal da Bahia. Instituto de Matemática. Departamento de Estatística. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Matemática. Departamento de Estatística. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Bio-Manguinhos. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Curitiba, PR, Brasil.
Molecular Biology Institute of Paraná. Curitiba, PR, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Fio-Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Carlos Chagas. Curitiba, PR, Brasil / Molecular Biology Institute of Paraná. Curitiba, PR, Brazil.
Fundação Oswaldo Cruz. Fio-Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
Universidade Federal da Bahia. Instituto de Matemática. Departamento de Estatística. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Matemática. Departamento de Estatística. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Bio-Manguinhos. Instituto de Tecnologia em Imunobiológicos. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Carlos Chagas. Curitiba, PR, Brasil.
Molecular Biology Institute of Paraná. Curitiba, PR, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Fio-Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Carlos Chagas. Curitiba, PR, Brasil / Molecular Biology Institute of Paraná. Curitiba, PR, Brazil.
Fundação Oswaldo Cruz. Fio-Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.
Abstract
The existence of an imperfect reference standard presents complications when evaluating the unbiased
performance of novel diagnostic techniques. This is especially true in the absence of a gold standard, as is the case in
chronic Chagas disease (CD) diagnosis. To circumvent this constraint, we elected to use latent class analysis (LCA).
Previously, our group demonstrated the high performance of four Trypanosoma cruzi–chimeric proteins (Molecular
Biology Institute of Parana´ [IBMP]-8.1, -8.2, -8.3, and -8.4) for CD diagnosis using several distinct immunoassays.
Although commercial tests had previously been established as a reference standard, the diagnostic performance of these
chimeric antigens could present bias because these tests fail to produce 100% accurate results. Thus, we used LCA to
assess the performance of these IBMP chimeric antigens in chronic CD diagnosis. Using the LCA model as a gold
standard, sensitivity and specificity values ranged from 93.5% to 99.4% and 99.6% to 100%, respectively. The accuracy
values were 96.2% for IBMP-8.2, approximately 98% for IBMP-8.1 and IBMP-8.3, and nearly 100% for IBMP-8.4. For
IBMP-8.1 and IBMP-8.2, higher positive predictive values were associated with increases in hypothetical prevalence.
Similarly, higher hypothetical prevalence resulted in lower negative predictive values for IBMP-8.1, IBMP-8.2, and IBMP-
8.3. In addition, samples with serodiscordant results from commercial serological tests were analyzed using LCA.
Molecular Biology Institute of Parana´ -8.1 demonstrated potential for use in confirmatory testing with regard to samples
with inconsistent results. Moreover, our findings further confirmed the remarkable performance of the IBMP-8.4 antigen to
diagnose chronic CD in both endemic and non-endemic areas.
Share