Immunodiagnosis of human hydatid disease: Where do we stand?

Table 1 Performance of hydatid cyst fluid in diagnosis of cystic echinococcosis in different serological assays

Antigen	No. of subjects			Test	Sensitivity (%)	Specificity (%)	Cross reactions	Year	Ref.
	CE patients	Other disease	Healthy control
SHCF	78	24	15	IgG ELISA	72.4		NR	2001	[71]
BHCF	129	65	203	IgG ELISA	77.6	96.6	Cysts, Toxoc.	2003	[44]
CHCF	26	35	10	Dipstick assay	100	91.4	Cysts, AE, Trichinosis, Schist., Fascio	2004	[6]
CHCF	26	35	10	EITB	100	91.4	Cysts, AE, trichinosis, Schist, Fascio	2004	[6]
CHCF	26	30	10	IgG ELISA	96.2	100	None	2004	[6]
SHCF	102	68	95	IgG ELISA	88.2	80.9	AE, Cysts, Schist, Fascio, Taeniasis, Dirofilariasis	2008	[72]
SHCF	120			Casoni’s skin test	88.2	80.9	NR	2005	[73]
SHCF	120			Casoni’s skin test	70	87	NR	2005	[73]
SHCF	120			Casoni’s skin test	62	85	NR	2005	[73]
SHCF	120			IHA	56	84	NR	2005	[73]
SHCF	25	15	25	ELISA on serum	72	76	Cysts, Ascaris, Ambs liver abscess	2007	[74]
SHCF	25	15	25	ELISA on urine	84	76	Cysts, Ascaris, Ambs liver abscess	2007	[74]
SHCF	25	15	25	ELISA on saliva	56	76	Cysts, Ascaris, Ambs liver abscess	2007	[74]
SHCF	40	40	70	CCIEP	97.5	58.1	Fascio, Toxoc, Taenia,	2007	[10]
							Malignancies
SHFF	204	53	90	IEP	31	100	None	2000	[75]
SHFF	204	53	90	IHA	54	100	None	2000	[75]
SHFF	204	53	90	IB	80	96	Cysts, Serous cysts	2000	[75]
SHCF	35	12	25	Dot-ELISA	100	89.1	Ascaris, Taenia,	2010	[1]
							Strogyl
SHCF	35	12	25	CCIEP	80	62	Ascaris, Strogyl,	2010	[1]
							Toxop
SHCF	59	60	39	IgG ELISA	91.5	96	Clonorchiasis	2013	[76]
hHCF	50	15	20	IB	83	98	None	2014	[28]
hHCF	50	15	20	IgG IB	83	98	None	2014	[28]
SHCF	50	40	20	IgG ELISA	92	85	Ascaris, Ambs,	2014	[67]
							Malignancy, Toxop
SHCF	50	40	20	IgM ELISA	70	93.33	Ascaris, Ambs,	2014	[67]
							Malignancy, Toxop
SHCF	50	40	20	IgE ELISA	86	96.66	Ascaris, Ambs,	2014	[67]
							Malignancy, Toxop
SHCF	50	40	20	IgG1 ELISA	82	98.33	Ascaris, Ambs, Malignancy, Toxop	2014	[67]
SHCF	50	40	20	IgG2 ELISA	74	95	Ascaris, Ambs,	2014	[67]
							Malignancy, Toxop
SHCF	50	40	20	IgG3 ELISA	52	36	Ascaris, Ambs, Malignancy, Toxop	2014	[67]
SHCF	50	40	20	IgG4 ELISA	86	28	Ascaris, Ambs,	2014	[67]
							Malignancy, Toxop
Psx Ag	113	112	121	DIGFA	87.6	90.90	Hd, Cysts,	2015	[48]
							HCC, HH
CPsx extract	147	88	60	IgG ELISA	90	57	AE, Trypanosomiasis	2002	[76]
Emwl Ag	50	154		WB IgG	98		NCC	2000	[14]
Emwl Ag	50	154		IHA > 80	94.3		NR	2000	[14]
Emwl Ag	50	154		IHA > 320	80		NR	2000	[14]
Emwl Ag	50	154		IgG ELISA	79.4		NR	2000	[14]

EITB: Enzyme linked immunoelectrotransfer blot; IHA: Immune hemagglutination assay; CHCF: Camel hydatid cyst fluid; SHCF: Sheep hydatid cyst fluid; hHCF: Human hydatid cyst fluid; SHFF: Sheep hydatid fluid fraction; Hd.: Hepatic distomiasis; Emwl Ag: Whole larval antigen from Echinococcus multilocularis; CPsx extract: Crude protoescolex extract; Psx Ag: Protoscoleces antigen; BHCF: Bovine hydatid cyst fluid; Ascaris: Ascariasis; Toxop: Toxoplasmosis; Fascio: Fascioliasis; Cysts: Cysticercosis; Ambs: Amebiasis; Toxoc: Toxocariasis; Schist: Schistosomiasis; AE: Alveolar echinococcosis; Strongyl: Strongyloidiasis; HH: Hepatic hemangioma; NR: Not reported; CE: Cystic echinococcosis; ELISA: Enzyme-linked immunosorbent assay.

Table 2 Performances of antigen 5 for immunodiagnosis of cystic echinococcosis in different serological assays

	No. of subjects			Test	Sensitivity (%)	Specificity (%)	Cross reaction	Year	Ref.
	CE patient	Other disease	Healthy control
Ag5	39	51	29	IgG ELISA	54	89	AE	2000	[9]
Ag5	58	36	40	IgG ELISA	100	70.17	Leish, Toxop, Fascio	2006	[39]
Ag5	58	36	40	IgG1 ELISA	100	70.17	Leish, Toxop, Fascio	2006	[38]
Ag5	58	36	40	IgG4 ELISA	75.8	93.02	Toxop, Fascio	2006	[38]
Ag5	58	36	40	IgE ELISA	70.1	100	None	2006	[38]
rAg5	34	36	18	IgG ELISA	65	89	AE, Cysts	2005	[77]
rAg5-38s	34	36	18	IgG ELISA	21	97	AE	2005	[77]

Leish: Leishmaniasis; Toxop: Toxoplasmosis; Fascio: Fascioliasis; Cysts: Cysticercosis; AE: Alveolar echinococcosis.

Table 3 Performances of antigen B in diagnosis of cystic echinococcosis

Antigen	No. of subjects			Test	Sensitivity (%)	Specificity (%)	Cross reactions	Year	Ref.
	CEpatients	Other disease	Healthy control
nAg B	204	21	90	IB	66	100	None	2000	[75]
nAg B	59	55	15	IgG ELISA	80	77	AE, NCC	2005	[77]
nAg B	90	86	27	IgG ELISA	77	85	AE, RA	2000	[9]
nAg B	204	21	90	IgG ELISA	74	100	None	2000	[75]
nAg B	31	87	29	IgG ELISA	77.41	81.9	AE, Ev, Schist, Toxoc	2000	[78]
nAg B	78	24	15	IgG ELISA	93.5	89.7	Distomatosis, Schist	2001	[71]
nAg B	129	65	203	IgG ELISA	60.3	92.6	Cysts,Toxoc	2003	[44]
nAg B	22	12	4	WB	77	100	Toxoc, Other cestodes	2010	[30]
nAg B	40	40	70	IgG ELISA	92.5	97.3	Fascio	2007	[10]
nAg B	40	40	70	CCIEP	97.5	58.2	Fascio, Toxoc, Taenia, Malignancy	2007	[10]
nAg B	204	53	90	IB	66	100	None	2000	[75]
nAg B	204	53	90	IgG ELISA	74	100	None	2000	[75]
nAg B	35	29	25	IgG ELISA	94.2	81.6	NR	2009	[16]
nAg B	55	72	50	IgG ELISA	96.4	97.2	None	2014	[68]
nAg B	113	112	121	DIGFA	92.9	81	HD, Cysts, HCC, HH	2015	[48]
Goat liver Ag B	47	30	40	IgG ELISA	91.4	92.8	NR	2011	[49]
Human liver Ag B	47	30	40	IgG ELISA	97.8	97.1	NR	2011	[49]
Bovine lung Ag B	47	30	40	IgG ELISA	78.7	85.7	NR	2011	[49]
Sheep lung Ag B	47	30	40	IgG ELISA	93.6	88.5	NR	2011	[49]
Camel lung Ag B	47	30	40	IgG ELISA	93.6	90	NR	2011	[49]
Sheep liver Ag B	47	30	40	IgG ELISA	95.7	92.8	NR	201	[49]
rAgB	204	21	90	IB	72	100	None	2000	[75]
rAgB	113	112	121	DIGFA	77.9	98.3	None	2015	[48]
rAgB8/1	31	87	29	IgG ELISA	54.84	80.17	AE, Schist, Toxoc	2000	[78]
rAgB8/1	129	65	203	IgG4 ELISA	91.4	91.7	Cysts	2003	[44]
rAgB8/1	59	55	15	IgG ELISA	68	88	AE, NCC	2005	[80]
rAgB8/2	31	87	29	IgG ELISA	83.87	98.28	Schist, Toxoc	2000	[78]
rAgB8/2	129	65	203	IgG ELISA	93.1	99.5	Cysts, Toxoc	2003	[45]
rAgB8/2	129	65	203	IgG4 ELISA	69	87.5	Cysts	2003	[45]
rAgB8/2	59	55	15	IgG ELISA	45	86	AE, NCC	2005	[77]
rAgB8/1	129	65	203	IgG4 ELISA	91.4	91.7	Cysts	2003	[44]
rAgB8/1	59	55	15	IgG ELISA	68	88	AE, NCC	2005	[77]
rAgB8/2	31	87	29	IgG ELISA	83.87	98.28	Schist, Toxoc	2000	[78]
rAgB8/2	129	65	203	IgG ELISA	93.1	99.5	Cysts, Toxoc	2003	[44]
rAgB8/2	129	65	203	IgG4 ELISA	69	87.5	Cysts	2003	[44]
rAgB8/2	59	55	15	IgG ELISA	45	86	AE, NCC	2005	[77]
B1t	102	68	95	IgG ELISA	83.3	87.5	AE, Schist, Cysts, Fascio,	2008	[9]
B2t	102	68	95	IgG ELISA	91.2	93	Cysts, Schist, Fascio	2008	[9]
2B2t	186	174	110	IgG ELISA	87.6	99.1	AE, NCC, Hepatitis	2012	[9]
rEgAFFPt	129	65	203	IgG ELISA	58.6	95.6	Cysts, Toxoc	2003	[44]
rEgCaBP2	129	65	203	IgG ELISA	84.5	96.6	Cysts, Toxoc	2003	[44]
rEgcMDH	129	65	203	IgG ELISA	89.7	95.1	Cysts	2003	[44]
rEgAFFPf	129	65	203	IgG ELISA	69	89.7	Cysts, Toxoc	2003	[44]
rEpC1-GST	324	502	70	IgG IB	92.2	95.6	AE, NCC, Schist,	2003	[79]
							Liver cancer
rTPxEg	100	218	20	IgG IB	39	69.3	AE, NCC	2004	[78]
rEgG5	23	138	20	IgG IB	61	70	AE, Cysts	2004	[79]
E14t	102	68	95	IgG ELISA	35.3	91.7	Schist	2008	[9]
C317	102	68	95	IgG ELISA	58.8	80.9	AE, Cysts, Taeniasis, Schist,	2008	[9]
p65	90	86	27	IgG ELISA	44	96	AE, Schist, Toxoc	2000	[9]
p175	90	86	27	IgG ELISA	49	94	AE, Schist, Toxoc	2000	[9]
p176	90	86	27	IgG ELISA	80	93	AE, Schist, Toxoc,	2000	[9]
							Syph, Chagas
p177	90	86	27	IgG ELISA	38	92	AE, Toxoc, Syph,	2000	[9]
							Chagas
pGu4	90	86	27	IgG ELISA	18	98	AE	2000	[9]

Leish: Leishmaniasis; Toxop: Toxoplasmosis; Fascio: Fascioliasis; Cysts: Cysticercosis; Ascaris: Ascariasis; Syph: Syphilis; Ambs: Amebiasis; Toxoc: Toxocariasis; Schist: Schistosomiasis; NCC: Neurocysticercosis; AE: Alveolar echinococcosis; nAg B: Native antigen B; rAgB: Recombinant antigen B; Ev: Ev: Polycistic hydatid disease (E. vogeli); RA: Rheumatoid arthritis; HCC: Hepatocellular carcinoma; NR: Not reported; CE: Cystic echinococcosis; ELISA: Enzyme-linked immunosorbent assay.

Table 4 Performances of antigen detection assays in immunodiagnosis of cystic echinococcosis

Antigen	No. of subjects			Test	Sensitivity (%)	Specificity (%)	Cross reaction (%)	Year	Ref.
	CE patient	Other disease	Healthy control
Urinary antigen	40	24	25	Co-A	50	89.09	12.5	2000	[62]
Serum antigen	40	24	25	Co-A	73.08	94.23	12.5	2000	[62]
Serum antigen	35	29	25	IgG ELISA	25.7	98	3.4	2009	[16]
Serum antigen	141	25	25	LAT	72	98	4	2003	[7]
Serum antigen	40	24	25	CIEP	45	100	None	1997	[80]
Urinary antigen (ucon)	40	24	25	CIEP	22.5	95.91	8.33	1997	[80]
Urinary antigen (con)	40	24	25	CIEP	47.5	95.91	None	1997	[80]

ucon: Unconcentrated; con: Concentrated; CE: Cystic echinococcosis; LAT: Latex agglutination test; Co-A: Coagglutination; CIEP: Countercurrent immunoelectrophoresis; ELISA: Enzyme-linked immunosorbent assay.