DETECTION OF CIRCULATING PARACOCCIDIOIDES-BRASILIENSIS ANTIGEN IN URINE OF PARACOCCIDIOIDOMYCOSIS PATIENTS BEFORE AND DURING TREATMENT

For the diagnosis and follow-up of paracoccidioidomycosis patients und ergoing therapy, we evaluated two methods (immunoblotting and competit ion enzyme immunoassay) for the detection of circulating antigen in ur ine samples. A complex pattern of reactivity was observed in the immun oblot test. Bands of 70 and 43 kDa were detected more often in urine s amples from patients before treatment, The immunoblot method detected gp43 and gp70 separately or concurrently in 11 (91.7%) of 12 patients, whereas the competition enzyme immunoassay detected antigenuria in 9 (75%) of 12 patients. Both tests appeared to be highly specific (100%) , considering that neither fraction detectable by immunoblotting was p resent in urine samples from the control group. gp43 remained present in the urine samples collected during the treatment period, with a sig nificant decrease in reactivity in samples collected during clinical r ecovery and increased reactivity in samples collected during relapses. Reactivity of some bands was also detected in urine specimens from pa tients with ''apparent cure.'' The detection of Paracoccidioides brasi liensis antigens in urine appears to be a promising method for diagnos ing infection, for evaluating the efficacy of treatment, and for detec ting relapse.