Distribution of IgG subclasses in antimonial unresponsive Indian kala‐azar patients

Sodium antimony gluconate (SAG) is the mainstay of treatment for visceral leishmaniasis (VL) or kala‐azar. In view of the increasing incidence of refractoriness to SAG in India, we compared the levels of parasite‐specific IgG and IgG subclasses in 20 longitudinally followed up kala‐azar patients. In both SAG‐responsive (n = 10) and unresponsive patients (n = 10), the levels of total IgG, IgG1, IgG2, IgG3 and IgG4 were increased, the rank order being IgG1 > IgG2 > IgG3 = IgG4. Following treatment, a significant decrease in total IgG and the four subclasses occurred in the SAG‐responsive group, whereas in the SAG‐unresponsive group these levels were unchanged or slightly increased. Therefore, monitoring of IgG1 and IgG2 levels in Indian kala‐azar patients is a good serologic alternative to monitoring the disease status.

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