Serological follow-up in patients with aorto-iliac disease and evidence of Q fever infection
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The aim of this study was to provide data on the risk of developing chronic Q fever in patients with aorto-iliac disease and evidence of previous Q fever infection. Patients with an aortic and/or iliac aneurysm or aorto-iliac reconstruction (aorto-iliac disease) and evidence of previous Q fever infection were included. The presence of phase I and II Coxiella burnetii IgG antibodies was assessed periodically using immunofluorescence assay. A total of 111 patients with aorto-iliac disease were divided into three groups, based upon the serological profile [mean follow-up: 16 ± 9 months (mean ± standard deviation)]. Group 1 consisted of 30 patients with a serological trace of C. burnetii infection (negative IgG phase I, IgG phase II titer of 1:32). Of these, 36.7 % converted to serological profile matching past resolved Q fever. Group 2 included 49 patients with negative IgG phase I titer and IgG phase II titer ≥1:64. No patients developed chronic Q fever, but 14.3 % converted to a positive IgG phase I titer. Group 3 consisted of 32 patients with positive IgG phase I and positive IgG phase II titers, of which 9.4 % developed chronic Q fever (significantly different from group 2, p = 0.039). The IgG phase I titer increased in 28.1 % of patients (from 1:64 to 1:4,096). The risk of developing chronic Q fever in patients with aorto-iliac disease and previous Q fever infection with a positive IgG phase I titer was 9.4 %. The IgG phase I titer increases or becomes positive in a substantial number of patients. A standardized serological follow-up is proposed.
KeywordsInitial Infection Coxiella Burnetii Fever Patient Serological Profile Iliac Aneurysm
This study was financially supported by the Netherlands Organisation for Health Research and Development (ZonMw, grant no. 205520001). The sponsor had no involvement in the study design, data collection, data analysis, or interpretation of the study results. The authors declare no conflict of interest.
We would like to thank Bart Verhoeven, Ruud van Loenhout, and Ronald van den Haak, vascular surgeons, Jeroen Bosch Hospital, ’s-Hertogenbosch, and dr. T. Smits, dr. H. de Geus, and dr. M. Booster, vascular surgeons, Bernhoven Hospital, Uden, for their participation in recruiting patients for screening. We would like to thank Olivier Dams for approving the manuscript grammatically.
Conflict of interest
The authors declare no conflict of interest.
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