Clinical and diagnostic relevance of the Toxoplasma IgG avidity test in the serological surveillance of pregnant women in Austria.

For evaluation of the medical relevance of a Toxoplasma IgG avidity test within the Austrian program for screening of pregnant women, 23 sera from women with seroconversions (group 1) and with proven latent Toxoplasma infections (group 3), respectively, as well as 92 sera from women suspected of having a primary infection (group 2) were tested by the indirect immunofluorescence test (IFAT), Sabin-Feldman's dye test (SFT), IgM enzyme-linked immunofluorescence assay (ELFA-IgM), IgA microparticle enzyme immunoassay, and the IgG avidity test. Group 1 sera (seroconversions) revealed a median avidity index (AI) of 0.25, whereas the median AI of group 3 sera (latent infections) was 0.66. In 31 (33.7%) of 92 cases suspected of involving a primary Toxoplasma infection, low (<0.41) or borderline AIs (0.41-0.50) were assessed, and in 61 cases (66.3%) the AIs exceeded 0.50. Finally, a recent infection could be excluded due to the results of the IgG avidity test in 59 cases; in at least 34 IgM-positive cases an unnecessary and, thus, unjustified treatment could be avoided.