Evaluation of indirect fluorescent antibody test and enzyme-linked immunosorbent assay for diagnosis of hepatic amebiasis in Bangladesh.

Serum samples of 31 amebic liver abscess (ALA) patients, 8 amebic hepatitis (AH) patients, and 60 controls were tested for anti-amebic IgG by enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody tests (IFAT). Sera of 29 (93.6%) ALA and 6 (75%) AH patients and 2 (3.3%) control subjects were positive by IFAT. Anti-amebic antibody titer above the cutoff point (= 0.168; x + 2 SD of control sera) was observed in sera of 27 (87%) ALA, 4 (50%) AH, and 1 (1.7%) control by ELISA. All the 8 pus samples were positive for anti-amebic antibodies by IFAT and ELISA. Sensitivity of ELISA was 87% for ALA, with a positive predictive value of 0.96, and 50% for AH cases, with a positive predictive value of 0.80. The sensitivity of IFAT was 93.6% for ALA, with a positive predictive value of 0.94, and 75% for AH, with a positive predictive value of 0.75. When pus samples were tested, the sensitivity was 100% for both tests. The specificity was 98.3% for ELISA and 96.7% for IFAT. Although not significant, IFAT was found more sensitive than ELISA (P>0.05).