Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review

Chronic infection with Toxoplasma gondii is attested by the detection of specific anti-Toxoplasma IgG. A wide panel of serologic methods is currently marketed, and the most suitable method should be chosen according to the laboratory resources and the screened population. This systematic review of e...

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Main Authors: Robert-Gangneux Florence, Guegan Hélène
Format: Article
Language:English
Published: EDP Sciences 2021-01-01
Series:Parasite
Subjects:
Online Access:https://www.parasite-journal.org/articles/parasite/full_html/2021/01/parasite210023/parasite210023.html
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author Robert-Gangneux Florence
Guegan Hélène
author_facet Robert-Gangneux Florence
Guegan Hélène
author_sort Robert-Gangneux Florence
collection DOAJ
description Chronic infection with Toxoplasma gondii is attested by the detection of specific anti-Toxoplasma IgG. A wide panel of serologic methods is currently marketed, and the most suitable method should be chosen according to the laboratory resources and the screened population. This systematic review of evaluation studies aimed at establishing an overview of the performances, i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of marketed anti-Toxoplasma IgG assays, and discussing their technical characteristics to guide further choice for routine diagnostic use. According to PRISMA guidelines, the search performed in PubMed and Web of Science databases recovered 826 studies, of which 17 were ultimately included. Twenty commercial anti-Toxoplasma IgG assays were evaluated, in comparison with an accepted reference method. Most of them were enzyme-immunoassays (EIAs, n = 12), followed by agglutination tests (n = 4), immunochromatographic tests (n = 3), and a Western-Blot assay (WB, n = 1). The mean sensitivity of IgG assays ranged from 89.7% to 100% for standard titers and from 13.4% to 99.2% for low IgG titers. A few studies pointed out the ability of some methods, especially WB to detect IgG early after primary infection. The specificity of IgG assays was generally high, ranging from 91.3% to 100%; and higher than 99% for most EIA assays. The PPV was not a discriminant indicator among methods, whereas significant disparities (87.5%–100%) were reported among NPVs, a key-parameter assessing the ability to definitively rule out a Toxoplasma infection in patients at-risk for opportunistic infections.
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spelling doaj.art-94105794ac1846dca50ebafb6a1654ca2023-12-02T08:49:42ZengEDP SciencesParasite1776-10422021-01-01283910.1051/parasite/2021035parasite210023Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic reviewRobert-Gangneux Florence0https://orcid.org/0000-0003-4493-596XGuegan Hélène1Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085Chronic infection with Toxoplasma gondii is attested by the detection of specific anti-Toxoplasma IgG. A wide panel of serologic methods is currently marketed, and the most suitable method should be chosen according to the laboratory resources and the screened population. This systematic review of evaluation studies aimed at establishing an overview of the performances, i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of marketed anti-Toxoplasma IgG assays, and discussing their technical characteristics to guide further choice for routine diagnostic use. According to PRISMA guidelines, the search performed in PubMed and Web of Science databases recovered 826 studies, of which 17 were ultimately included. Twenty commercial anti-Toxoplasma IgG assays were evaluated, in comparison with an accepted reference method. Most of them were enzyme-immunoassays (EIAs, n = 12), followed by agglutination tests (n = 4), immunochromatographic tests (n = 3), and a Western-Blot assay (WB, n = 1). The mean sensitivity of IgG assays ranged from 89.7% to 100% for standard titers and from 13.4% to 99.2% for low IgG titers. A few studies pointed out the ability of some methods, especially WB to detect IgG early after primary infection. The specificity of IgG assays was generally high, ranging from 91.3% to 100%; and higher than 99% for most EIA assays. The PPV was not a discriminant indicator among methods, whereas significant disparities (87.5%–100%) were reported among NPVs, a key-parameter assessing the ability to definitively rule out a Toxoplasma infection in patients at-risk for opportunistic infections.https://www.parasite-journal.org/articles/parasite/full_html/2021/01/parasite210023/parasite210023.htmlanti-toxoplasma iggdiagnosisserologytoxoplasmosissensitivityspecificity
spellingShingle Robert-Gangneux Florence
Guegan Hélène
Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
Parasite
anti-toxoplasma igg
diagnosis
serology
toxoplasmosis
sensitivity
specificity
title Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
title_full Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
title_fullStr Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
title_full_unstemmed Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
title_short Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review
title_sort anti toxoplasma igg assays what performances for what purpose a systematic review
topic anti-toxoplasma igg
diagnosis
serology
toxoplasmosis
sensitivity
specificity
url https://www.parasite-journal.org/articles/parasite/full_html/2021/01/parasite210023/parasite210023.html
work_keys_str_mv AT robertgangneuxflorence antitoxoplasmaiggassayswhatperformancesforwhatpurposeasystematicreview
AT gueganhelene antitoxoplasmaiggassayswhatperformancesforwhatpurposeasystematicreview