Discrimination between primary and secondary Dengue virus infection by an immunoglobulin G avidity test using a single acute-phase serum sample
Discrimination between primary and secondary Dengue virus infection by an immunoglobulin G avidity test using a single acute-phase serum sample
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DOI：
10.1128/jcm.43.6.2793-2797.2005
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发表时间：
2005-06-01
影响因子：
9.4
通讯作者：
Dussart, P
中科院分区：
文献类型：
--
作者：
Matheus, S;Deparis, X;Dussart, P
为了临床和流行病学的目的，有必要能够对登革病毒感染期间的血清学反应进行分类。因此，重要的是要开发一种测试，可以区分原发性和继发性血清学反应。目前世界卫生组织推荐的血凝抑制（HI）试验执行起来很复杂。我们开发了一种酶联免疫吸附试验的基础上的免疫球蛋白G的亲和力在感染发作的变化。该测试可以通过使用在感染急性期收集的单个血清样本来区分原发性和继发性感染。我们对118对血清样本或连续样本进行了1，140次亲合力测量，这些样本取自根据世界卫生组织实验室标准分类为原发性或继发性感染的患者。初次感染时的平均亲合力百分比（25.9%）显著低于继发感染时的平均亲合力百分比（66.3%）（Student t检验，P < 0.001）。该试验的灵敏度为82.7%（95%置信区间[CI] = 79.0至86.6），特异性为77.5%。(95% CI = 73.3至81.7）。基于仅在疾病的第三天和第七天之间收集的血液样本的分析，在此期间大多数临床并发症发生，该测试的灵敏度和特异性分别为95.1%（95%CI = 92.6至97.7）和80.0%（95%CI = 75.3至84.7）。这种快速和简单的测试似乎是一个很好的替代HI测试区分原发性和继发性登革热病毒感染在登革热的急性期。
For clinical and epidemiological purposes, it is necessary to be able to classify serological responses during dengue virus infection. Thus, it is important to develop a test that can distinguish between primary and secondary serological responses. The hemagglutination inhibition (HI) test, which is currently recommended by the World Health Organization, is complicated to perform. We developed an enzyme-linked immunosorbent assay based on changes in the avidity of immunoglobulin G during the infectious episode. This test can discriminate between primary and secondary infections by using a single serum sample collected during the acute phase of infection. We took 1,140 avidity measurements with 118 pairs of serum samples or sequential samples taken from patients classified as having primary or secondary infection according to World Health Organization laboratory criteria. The mean percent avidity was significantly lower during primary infection (25.9%) than during secondary infection (66.3%) (Student t test, P < 0.001). The test had a sensitivity of 82.7% (95% confidence interval [CI] = 79.0 to 86.6) and a specificity of 77.5%. (95% CI = 73.3 to 81.7). Based on analysis of only blood samples collected between the third and seventh days of the illness, during which most clinical complications occur, the sensitivity and specificity of the test were 95.1% (95% CI = 92.6 to 97.7) and 80.0% (95% CI = 75.3 to 84.7), respectively. This rapid and simple test appears to be an excellent alternative to the HI test for discriminating between primary and secondary dengue virus infections during the acute phase of dengue.