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Clinical and Vaccine Immunology, October 2009, p. 1517-1520, Vol. 16, No. 10
1071-412X/09/$08.00+0     doi:10.1128/CVI.00253-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Spiramycin Treatment of Toxoplasma gondii Infection in Pregnant Women Impairs the Production and the Avidity Maturation of T. gondii-Specific Immunoglobulin G Antibodies{triangledown}

V. Meroni,1,2* F. Genco,2 C. Tinelli,3 P. Lanzarini,2 L. Bollani,4 M. Stronati,4 and E. Petersen5

Department of Infectious Diseases, University of Pavia, Pavia, Italy,1 Department of Infectious Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy,2 Clinical Epidemiology and Biometric Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy,3 Neonatal Intensive Care Unit, IRCCS Policlinico San Matteo Foundation, Pavia, Italy,4 Department of Infectious Diseases, Aarhus University Hospital, Skejby Aarhus, Denmark5

Received 17 June 2009/ Returned for modification 17 July 2009/ Accepted 12 August 2009

The aim of the study was to evaluate the influence of treatment with spiramycin on the increase of immunoglobulin G (IgG) titers and IgG avidity indexes (AI) in pregnant women with seroconversion from the beginning of therapy until delivery and after delivery. This group was compared with adult patients with recently acquired untreated toxoplasmosis. One hundred four samples from 32 pregnant women with seroconversion for toxoplasmosis and/or very low IgG AI were followed from the beginning of therapy with spiramycin until delivery. Twenty-nine women were further followed some months after delivery and interruption of therapy. Thirty-eight samples from 16 untreated, nonpregnant patients were evaluated as the control group. The Toxoplasma gondii-specific IgG antibody and the T. gondii-specific IgG AI were significantly delayed in pregnant women receiving therapy compared to nonpregnant, untreated controls, and the findings were consistent with the results of assays from two different manufacturers. The T. gondii-specific IgG AI increased in pregnant women after they gave birth. Avidity maturation is delayed during pregnancy and treatment, and low-avidity antibodies in pregnant women within 3 to 4 months cannot be taken as a sign of infection.

* Corresponding author. Mailing address: Dipartimento di Malattie Infettive, Università degli Studi di Pavia, Fondazione IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy. Phone: 00390382502631. Fax: 0039382501808. E-mail: v.meroni{at}smatteo.pv.it

{triangledown} Published ahead of print on 19 August 2009.

Clinical and Vaccine Immunology, October 2009, p. 1517-1520, Vol. 16, No. 10
1071-412X/09/$08.00+0     doi:10.1128/CVI.00253-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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