Resumo
Os testes sorológicos para diagnóstico de hanseníase, usando o glicolipídeofenólico, considerado antígeno específico do M. leprae têm aberto algumas possibilidades de estudo do comportamento epidemiológico desta doença. Foi realizado um estudo para medir a sensibilidade e especificidade de um teste de ELISA anti PGL-1, usando material e técnica proveniente de Cuba (UMELISA). Foram testados 84 doentes e 112 controles sadios. A sensibilidade do teste foi maior para o grupo de doentes multibacilares, sendo mais alto entre os casos classificados como virchowianos (V), seguido dos dimorfos (D). No grupo de multibacilares, considerando o limiar de reatividade de 0,200, observou-se que apenas 75,0% de pacientes V e 50,0% de D foram positivos ao teste e, no limiar de 0,300, apenas 64,3% dos V e 40,0% dos D ainda mostravam positividade. Os doentes indeterminados apresentaram maior proporção de soropositivos do que os tuberculóides e isto talvez traduza a polarização de alguns casos para formas multibacilares. A especificidade do teste foi de 87,5% no limiar de 0,200 e de 99,1% no de 0,300. Este teste, à semelhança de outros, apresentou alta especificidade e baixa sensibilidade, resultando em grande percentual de falso-negativos. Para uma doença em que os testes sorológicos são escassos, apesar de não se recomendar o uso indiscriminado do teste para triagem de casos na população geral, a continuidade de seu aprimoramento tecnológico deve ser estimulada. Conseguir-se-ia, assim, avançar na pesquisa de instrumentos cada vez mais sensíveis e específicos para melhorar o diagnóstico precoce e, desse modo intervir mais oportunamente na cadeia de transmissão.
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