The reduction of the number of lumbar punctures performed during the follow-up of patients affected by sleeping sickness (HAT) is considered a research priority. Follow-up, consisting of the examination of cerebrospinal fluid (CSF) for presence of parasites and for the number of leukocytes, is necessary to assess treatment outcome. However, diagnosis of treatment failure is still imperfect and WHO encourages improvements in defining criteria. Many studies have attempted to standardize actual methods and to define a cut-off for the number of white blood cells in CSF to define relapses, while only few have proposed alternatives to current practice. Here we show that neopterin, already proven to be a powerful marker for staging T. b. gambiense HAT, is also useful in evaluating post-therapeutic outcome. The measurement of neopterin concentration in CSF during the follow-up may allow reduction in the number of lumbar punctures from five to three for the majority of cured patients.
Tiberti, N.; Lejon, V.; Hainard, A.; Courtioux, B.; Robin, X.; Turck, N.; Kristensson, K.; Matovu, E.; Enyaru, J.C.; Ngoyi, D.M.; Krishna, S.; Bisser, S.; Ndung’u, J.M.; Büscher, P.; Sanchez, J.C. Neopterin Is a Cerebrospinal Fluid Marker for Treatment Outcome Evaluation in Patients Affected by Trypanosoma brucei gambiense Sleeping Sickness. PLoS Neglected Tropical Diseases (2013) 7 (2) e2088. [DOI: 10.1371/journal.pntd.0002088]