Keywords
immunity
treatment efficacy
prognosis
How to Cite
Abstract
Introduction. The role of immune defence mechanisms against parasitic infections, particularly blastocystosis, is undeniable. In this regard, its role as a predictor of the effectiveness of blastocystosis treatment, particularly during treatment with secnidazole, cannot be ruled out.
Aim. To determine the prognostic value of immune markers in relation to the efficacy of treatment with secnidazole in patients with blastocystosis, and to develop a prognostic algorithm based on these findings.
Materials and methods. In order to determine the prognostic value of immunological parameters, the values of these parameters were retrospectively analysed in 96 patients with blastocystosis aged between 17 and 54 years, divided into the following groups: Group A – with a good therapeutic response (n = 59) and Group B – with a satisfactory response (n = 37).
Group A comprised patients in whom the degree of regression of clinical symptoms was ≥ 31% one month after the start of treatment, whilst Group B comprised patients in whom it was ≤ 30%. The criterion for a short-term prognosis was the efficacy of treatment one month after the start of treatment.
Results. An initial analysis revealed statistically significant differences between the groups for most indicators, which formed the basis for developing a predictive algorithm using the Wald-Henkin heterogeneous sequential procedure (Gubler E.V., 1978). It was found that most of the parameters demonstrated high prognostic value, namely: Ig A levels (J = 4,36), Ig G (J = 4,23), Ig M (J = 1,69), Ig E (J = 1,57), CRP (J = 1,47), as well as CD3 levels (J = 3,22), T-active lymphocytes (J = 2,22), CD19 (J = 1,58) and CD4 (J = 1,10). Moderate prognostic properties were established for CD8 count (J = 0,66) and low prognostic properties for IRI (J = 0,21).
Conclusions. Testing of the predictive algorithm with a 95% confidence level on the training set (n = 96) demonstrated high effectiveness, as the proportion of incorrect predictions was 2.4% and did not exceed the specified confidence level of 5%; correct predictions were recorded in 88.1% of cases, and uncertain predictions in 9.5% of cases.
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