IGG, IGM AND IGA ANTIBODY-RESPONSE FOR THE DIAGNOSIS AND FOLLOW-UP OFPARACOCCIDIOIDOMYCOSIS - COMPARISON OF COUNTERIMMUNOELECTROPHORESIS AND COMPLEMENT-FIXATION

IgG, ISM and IgA antibodies to GP43 (glycoprotein fraction of Paracocc idioides brasiliensis) were measured by ELISA in 63 samples from 23 pa tients with paracoccidioidomycosis before and twice after chemotherapy was started. Antibodies against P. brasiliensis were detected by indi rect immunofluorescence (IF) (IgG, IgM and IgA isotypes), counterimmun oelectrophoresis (CIE) and complement fixation. Two control groups com posed of 19 healthy individuals and 12 patients with other diseases (s ix with histoplasmosis, three with tuberculosis and three with other m ycoses). The highest efficiency percentages were found with IgG and Ig A-ELISA (100%), IgG-IF (96.2%), CIE (94.4%) and the lowest with CF (75 .9%). Highest positive and negative predictive values (100%) were obse rved for IgG and ISA ELISA. IgG and IgM-ELISA antibodies are more ofte n found in patients with acute than chronic disease (P=0.01). Four to six months after treatment follow-up showed decreased levels of IgG an d ISM-ELISA for acute cases and decreased titres of CIE for chronic ca ses in relation to pretreatment levels. This study suggests that IgG-E LISA anti-GP43 represents a good marker to monitor clinical response t o therapy.