Abstract
BackgroundDengue is an acute febrile illness considered the major arboviral disease in terms of morbidity, mortality, economic impact and dissemination worldwide. Brazil accounts for the highest notification rate, with circulation of all four dengue serotypes. The NS1 antigen is a dengue highly conserved specific soluble glycoprotein essential for viral replication and viability that can be detected 0 to 18 days from the onset of fever (peak first 3 days). It induces a strong humoral response and is known as a complement-fixing antigen. Lower NS1 test sensitivity occurs in secondary dengue infections probably due to immune complex formation impairing antigen detection by ELISA.MethodsWe compared the sensitivity of NS1 ELISA in heat dissociated and non-dissociated samples from 156 RT-PCR confirmed acute dengue-4 cases from 362 prospectively enrolled patients.ResultsSecondary infections accounted for 83.3% of cases. NS1 ELISA was positive in 42.5% and indeterminate in 10.2% of dengue-4 cases. After heat dissociation, 7 negative and 16 indeterminate samples turned positive, increasing the overall test sensitivity to 57.7%.ConclusionsAlthough it is time consuming and requires the use of specific laboratory equipment, NS1 ELISA combined with heat dissociation could be a slightly better alternative for triage in suspected dengue cases.
Highlights
Dengue is an acute febrile illness considered the major arboviral disease in terms of morbidity, mortality, economic impact and dissemination worldwide
Nonstructural protein-1 (NS1) Ag is a dengue highly conserved specific soluble glycoprotein essential for viral replication and viability that can be detected in dengue patients from day 1 up to 18 days after fever onset [7] with peak sensitivity in the first 3 days of fever onset [8]
Eligible adult patients who presented to a public outpatient unit (Unidade de Pronto Atendimento-UPA 24H) within 72 h of a febrile illness without an evident source of infection were interviewed and examined by the investigators
Summary
Dengue is an acute febrile illness considered the major arboviral disease in terms of morbidity, mortality, economic impact and dissemination worldwide. The NS1 antigen is a dengue highly conserved specific soluble glycoprotein essential for viral replication and viability that can be detected 0 to 18 days from the onset of fever (peak first 3 days) It induces a strong humoral response and is known as a complement-fixing antigen. Since 2008, all NS1 Ag is a dengue highly conserved specific soluble glycoprotein essential for viral replication and viability that can be detected in dengue patients from day 1 up to 18 days after fever onset [7] with peak sensitivity in the first 3 days of fever onset [8] It induces a strong humoral response and is known as a complement-fixing antigen [9]
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