Abstract
Considering the short lifetime of IgA antibodies in serum and the key advantages of antibody detection ELISAs in terms of sensitivity and specificity, Bio-Rad has just developed a new ELISA test based on the detection of specific anti-dengue IgA. This study has been carried out to assess the performance of this Platelia Dengue IgA Capture assay for dengue infection detection. A total of 184 well-characterized samples provided by the French Guiana NRC sera collection (Laboratory of Virology, Institut Pasteur in French Guiana) were selected among samples collected between 2002 and 2013 from patients exhibiting a dengue-like syndrome. A first group included 134 sera from confirmed dengue-infected patients, and a second included 50 sera from non-dengue infected patients, all collected between day 3 and day 15 after the onset of fever. Dengue infection diagnoses were all confirmed using reference assays by direct virological identification using RT-PCR or virus culture on acute sera samples or on paired acute-phase sera samples of selected convalescent sera. This study revealed: i) a good overall sensitivity and specificity of the IgA index test, i.e., 93% and 88% respectively, indicating its good correlation to acute dengue diagnosis; and ii) a good concordance with the Panbio IgM capture ELISA. Because of the shorter persistence of dengue virus-specific IgA than IgM, these results underlined the relevance of this new test, which could significantly improve dengue diagnosis accuracy, especially in countries where dengue virus is (hyper-) endemic. It would allow for additional refinement of dengue diagnostic strategy.
Highlights
Caused by any of four dengue virus serotypes (i.e. DENV-1 to DENV-4), dengue infection is currently the most significant arthropod-borne viral disease [1]
According to the kinetics of dengue infection in serum, virus isolation and nucleic acid or antigen detection are the most specific diagnostic methods during the early acute stage of disease; serology is often used for diagnosis later in the course of infection
In order to provide an earlier and reliable dating of the dengue infection, few recent studies showed that the detection of specific IgA in the serum is a useful diagnostic parameter
Summary
Caused by any of four dengue virus serotypes (i.e. DENV-1 to DENV-4), dengue infection is currently the most significant arthropod-borne viral disease [1]. Whereas the World Health Organization (WHO) estimated in 2009 that 50–100 million infections occur each year [1], a recent study estimated that 390 million dengue infections occurred annually, of which more than 90 million were symptomatic [2]. During the acute phase of the disease, dengue diagnosis is based on direct viral detection targeting the genome, especially by RT-PCR approaches, virus isolation on culture cell, or a viral antigen, the non-structural protein 1 (NS1) by ELISA or rapid tests. Indirect methods of dengue diagnosis are based on dengue-specific antibody detection, the specific immunoglobulin M (IgM) by an IgM antibody-capture enzyme-linked immunoabsorbent assay (MAC ELISA), and virus-specific IgG and IgA. Different commercial kits are available to detect these specific antibodies [1,3,5,7]
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