This study was performed to differentiate serologically between patients with hydatid disease which is active, and which has been successfully cured. A total of 18 cases was included. Pre-treatment serum samples were collected before surgery or chemotherapy. Post-treatment serum samples were collected at various intervals (3 days, 7 days, 1 month, 6 months, 1 year and 2 years) after surgery or chemotherapy. These sera were tested for the presence of circulating hydatid antigen (CAg) by bacterial co-agglutination (Co-A) and counter-current immunoelectrophoresis (CIEP) tests, and for circulating hydatid antibodies (CAb) by indirect haemagglutination assay (IHA). Ten and eight sera, respectively, were positive out of 11 pre-operative and pre-chemotherapeutic sera tested for CAg by the Co-A and CIEP tests. Post-operative sera collected from these cases did not show any CAg by the CIEP test. However, CAg was detected by Co-A in three and four serum samples collected on the third and seventh day, respectively, after surgical removal of the cyst. However, the CAg levels in these post-operative sera showed a gradual decline by the seventh day and were completely absent in the serum specimens collected 1 month after surgery and 6 months after chemotherapy. All the post-operative serum samples except.two, collected 2 years after surgical removal of the cyst, in seven cases of old hydatid disease, were negative for CAg by both the CIEP and Co-A tests. Unlike the CAg profile, no marked differences were noted between the CAb profile of the pre- and post-treatment sera, as shown by the IHA test. Even 1 year after surgery or chemotherapy, two sera showed a marginal decrease in their CAb titre. CAb at varying titres was still detectable in all seven serum samples from old cases of hydatid disease, even 2 years after surgical removal of the cyst. This study shows the value of serial pre- and post-operative or chemotherapy estimation of CAg by Co-A and CIEP as an index of cure or of continuing hydatid infection.


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