IgG Test Research Articles

Cross-sectional evaluation of anti-SARS-CoV-2 antibody response to AZD1222 recombinant vaccine deployment in the Bono region, Ghana

BackgroundPreliminary data across the globe shows that the AZD1222 recombinant vaccine was highly effective in preventing not only the symptoms but also the transmission of the SARS-CoV-2 virus. In Ghana, data on the immune response generated by different vaccination doses is lacking. The present study aimed to compare the anti-SARS-CoV-2 antibody response among single and double-vaccinated versus unvaccinated individuals. MethodsA case-control design was employed for this study. Seventy-nine participants (35 vaccinated, 44 unvaccinated) were recruited from the Sunyani West municipality and screened for the presence of SARS-CoV-2 specific IgG and IgM antibodies in plasma samples using a Standard COVID IgG and IgM Combo immunoassay test. Data analysis was carried out with STATA (version 21). ResultsThe current study showed that mean IgG levels among vaccine groups (Group 1: Not vaccinated, Group 2: 1 dose, Group 3: 2 doses) differed significantly (F2, 76=11.457, p<.001) between Group 1 and Group 3; and between Group 2 and Group 3. Participants in Group 2 and Group 3 were 4.1 and 12.5 times more likely to develop stronger antibody responses compared to their counterparts in Group 1 respectively. ConclusionThis baseline study demonstrated that in the short term, individuals who received either one or two doses of the AZD1222 recombinant vaccine generated a higher antibody response compared to individuals who did not receive any dose of the vaccine. Further studies are needed to understand how long the generated immune response will last in this population and whether a booster shot could be a useful strategy.

Clinical applications of immunoglobulin G against different individual Aspergillus species for the diagnosis of chronic pulmonary aspergillosis among at-risk populations

ABSTRACT Aspergillus fumigatus-specific IgG is often used as a diagnostic test for chronic pulmonary aspergillosis (CPA), but few studies have evaluated the performance and serology of IgGs from species other than A. fumigatus. In this study, we evaluated the serology and performance of different Aspergillus species-specific IgG antibodies in patients with CPA and at-risk populations and whether different Aspergillus species-specific IgGs could be of clinical utility and aid in the diagnosis of CPA caused by all Aspergillus species. A total of 187 participants were included between 2020 and 2022 (12 with CPA, 75 with old tuberculosis [TB], 45 with active TB and 55 with bronchiectasis). We measured the serum Aspergillus fumigatus, flavus, terreus, niger-specific, and mixed Aspergillus IgG levels (Phadia ImmunoCap). The correlation was the strongest between A. fumigatus and A. niger (Spearman’s rank: 0.940), followed by A. niger and A. flavus (Spearman’s rank: 0.915). A. terreus-specific IgG was less strongly correlated with the other three Aspergillus species-specific IgG (Spearman’s rank: 0.828–0.849). A. flavus (4 of 6, 67%) was the dominant species. Using the at-least-one-positive approach, the highest performance was obtained when A. fumigatus and A. flavus IgGs were used (sensitivity, 0.75; specificity, 0.84). Significant cross-reactivity exists among different Aspergillus-species IgGs although the correlation may be less significant for A. terreus. In addition to the commonly used A. fumigatus IgG test, IgGs specific to local prevalent Aspergillus species may provide additional clinical utility.

Prevalence and Sociodemographic Risk Factors of Soil-Transmitted Helminths in Rural Communities Living in Endemic Foci of Onchocerciasis in Southern Gabon.

This prospective survey determined the prevalence and intensity of infections due to geohelminths and the associated risk factors in five onchocerciasis-endemic communities in Gabon between January and February 2020. Onchocerciasis endemicity was confirmed by Ov16 IgG testing. STHs were detected using the Kato-Katz techniques. Prevalence and parasite density were analyzed according to age, sex, and onchocerciasis endemicity. STHs were found in 64.8% of participants and were more common in hypoendemic (80.9%) and hyperendemic (63.9%) onchocerciasis communities (p < 0.01). Ascaris lumbricoides (65.5%), Trichuris trichiura (57.1%), and hookworms (17.3%) were prevalent in areas hypoendemic for onchocerciasis (p = 0.04). Male participants were more often infected by hookworms. Adults were more frequently infected by STHs (75.9%) than elders, who were the least infected (39.3%) (p < 0.01). Participants living in sporadic onchocerciasis areas frequently but not significantly harbored a moderate ascariasis load (6960.0 (1068.0-9492.0) eggs per gram) (p = 0.4). The highest parasite density was observed among participants aged 20-45 years (15,336.0 (3888.0-35,028.0)). A low T. trichiuria prevalence was found in all communities. STHs are highly prevalent in hypoendemic and hyperendemic areas and adults. An integrated combined approach of STH and onchocerciasis elimination through efficacious mass drug administration targeting all age groups should be considered.

Pattern of IgG Testing and Immunoglobulin-Replacement Therapy in Patients with Non-Hodgkin Lymphoma

Pattern of IgG Testing and Immunoglobulin-Replacement Therapy in Patients with Non-Hodgkin Lymphoma

Serological and molecular detection of Toxoplasma gondii in cats in Europe with evaluation of associated risk factors for pathogen contact/infection.

Toxoplasma gondii is an obligate intracellular coccidian pathogen, with domestic cats and other members of the Felidae family serving as its definitive hosts. The aim of the study was to identify risk factors for positive test results. A laboratory database was screened for T gondii PCR results from faecal samples and serology results (IgM, IgG) from serum/plasma taken from cats in Europe between January 2008 and December 2022. Logistic regression analysis was performed to identify risk factors associated with positive T gondii results, such as breed, age, sex, neuter status, regionality, seasonality, feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) status. Odds ratios (ORs) were calculated. A total of 45,523 cats were included: 14,500 (31.9%) tested positive by direct and/or indirect detection methods for T gondii (PCR: 126/7896 [1.6%], IgG: 14,148/37,882 [37.3%], IgM: 1539/37,882 [4.1%]). Age >5 years (IgG: OR 2.591, P <0.001; IgM: OR 1.954, P <0.001), European domestic shorthair cats/cross breeds (IgG: OR 3.848, P <0.001; IgM: OR 2.152, P <0.001), male sex (IgG: OR 1.134, P <0.001), neuter status in male (IgG: OR 0.536, P <0.001) and female cats (IgG: OR 0.577, P <0.001), FeLV antigen positivity (IgG: OR 1.358, P = 0.030) and FIV antibody positivity (IgG: OR 2.350, P <0.001; IgM: OR 2.650, P <0.001) significantly impacted the serological results. In PCR testing, neuter status had a significant impact in male (OR 2.455, P = 0.002) and female cats (OR 2.988, P <0.001). Serological and PCR results were significantly influenced by regionality for IgG (central: OR 1.454, P <0.001; north: OR 0.768, P <0.001; south: OR 0.526, P <0.001; east: OR 0.768, P <0.001; west: OR 0.709, P <0.001), IgM (central: OR 0.616, P <0.001; north: OR 1.456, P <0.001; south: OR 1.767, P <0.001; east: OR 1.456, P <0.001) and PCR testing (central: OR 0.460, P <0.001; north: OR 3.020, P = 0.002; east: OR 3.020, P = 0.002). Seasonality had a statistically significant impact on IgM (summer: OR 1.402, P <0.001; winter: OR 0.732, P <0.001) and PCR testing (autumn: OR 1.473, P = 0.038). Breed, age, sex, neuter status, seasonality and regionality significantly impacted serological results. Neuter status, seasonality and regionality significantly impacted the PCR results. Immunosuppression (FeLV/FIV) had a significant impact on serological results. PCR-positive cats shed oocysts and spread infection to other susceptible hosts, including humans. Surveillance is therefore recommended, taking into consideration the associated risk factors.

The Multiple Facets of Cow’s Milk Allergy

Cow’s milk allergy (CMA) is one of the most common food allergies in early childhood. CMA has varied presentations and multiple facets. A detailed clinical history is key for classification. In IgE-mediated CMA skin prick testing and serum specific IgE testing are useful in the diagnosis, but an oral food challenge (OFC) may still be necessary if there is doubt or to assess tolerance. Non-IgE-mediated CMA presentations include food protein-induced allergic proctocolitis (FPIAP), food protein-induced enterocolitis syndrome (FPIES), and eosinophilic esophagitis (EoE). The diagnosis of FPIAP and FPIES is based on the clinical history. An esophageal biopsy is required for the diagnosis of EoE. Atopy patch testing, IgG or IgG4 testing are not helpful in any CMA evaluation. Children with CMA (except those with FPIAP) are at risk for poor growth and a nutritional evaluation should be part of routine care. Extensively hydrolyzed formulas are the recommended first choice alternative formula for CMA. For IgE-mediated CMA, alternative approaches to traditional strict avoidance include oral immunotherapy (OIT) and omalizumab (both as monotherapy and as an adjunct to OIT). Multiple international guidelines have addressed evaluation and management of CMA providing key information, support and guidance for clinicians in daily practice.

Multiple Liver and Jejunal Abscesses Due to Fasciola Flat Worm: An Uncommon Case Report from Iran.

Fascioliasis is a zoonotic condition precipitated by the trematode known as Fasciola spp. This parasite affected almost 2.4 to 17million individuals in the world. The occurrence of liver abscesses is an infrequent phenomenon, potentially arising as a secondary outcome of cholangitis or hepatic inflammation. In this study, we have reported a case of a hepatic abscess induced by Fasciola spp. A 29-year-old male presented with generalized abdominal discomfort, primarily concentrated in the right upper quadrant, which had progressively worsened over the past seven months. The patient did mention a weight loss of approximately 10kg during the course of their illness, along with increasing fatigue. Eosinophilia was seen too (35%). The stool exam test was negative. An enteroscopy was conducted, revealing no pathological abnormalities. Following this, the surgeon prescribed a surgical biopsy of the mass, which yielded a diagnosis of multiple eosinophilic granulomatous abscesses within the jejunal wall and mesentery. The Fasciola IgG test returned a positive result. After of follow-up, the patient fully recovered. Fascioliasis should be considered in the differential diagnoses of liver abscesses. Because of earlier diagnosis, can be avoided of invasive diagnostic tests and therapeutic interventions can be started earlier.

COVID-19 Vaccine-induced antibody response to BNT162b2 mRNA in frontline healthcare workers

The emergence of SARS-CoV-2, the virus causing COVID-19, has resulted in a pandemic that has disrupted all sectors of society. Less than a year after the sequencing of the virus’s genome, emergency use authorization for the BNT162b2 vaccine was requested. The aim of this study was to evaluate the response to the BNT162b2-mRNA COVID-19 vaccine in frontline workers from two hospitals in Colombia. Nasopharyngeal swabs were collected for the molecular detection of SARS-CoV-2 using real-time PCR, and blood samples were taken to assess seroconversion using qualitative and quantitative IgA, IgG, and IgM test kits. The study was conducted at a high-complexity healthcare institution in Bucaramanga, Colombia. 245 people were included in the first round and 129 in the second. SARS-CoV-2 molecular tests were conducted by RT-qPCR, and peripheral blood samples were collected to measure IgG, IgM, and IgA. The main outcome was to establish natural infection and the antibody response induced by the vaccine. The entire population was tested at two fixed times with RT-PCR tests and antibody level measurements approximately 4 and 8 months after receiving the second vaccine dose. 62 (25.3%) and 35 (14.3%) participants had a history of positive PCR in the first and second rounds, respectively. All positive cases showed elevated levels of all immunoglobulins, especially IgG. The average concentrations of IgA, IgM, and IgG at 90 days were 1149.5 U/mL (95% CI 828.2-1470.9); 320.3 U/mL (95% CI 218.4-422.3); and 9277.3 U/mL (95% CI 8989.2-9565.3). Frontline healthcare workers showed an adequate response to the BNT162b2 mRNA vaccine.

Comparison of the sensitivity and specificity of commercial anti-dengue virus IgG tests to identify persons eligible for dengue vaccination.

The Advisory Committee on Immunization Practices (ACIP) has set forth recommendations that dengue pre-vaccination screening tests must exhibit at least 98% specificity and 75% sensitivity. Our research rigorously assesses the performance of various commercial tests against these benchmarks using well-characterized specimens from Puerto Rico. The findings from our study are particularly relevant given FDA approval and ACIP recommendation of Sanofi Pasteur's Dengvaxia vaccine, highlighting the need for accurate pre-vaccination screening tools.

Evaluation of different standard and modified two-tier testing strategies for the laboratory diagnosis of lyme borreliosis in a European setting

BackgroundDiagnosis of Lyme borreliosis (LB) relies on clinical symptoms and detection of Borrelia-specific antibodies. Guidelines recommend a two-tier testing (TTT) strategy for disseminated LB: serological screening with a sensitive enzyme immunoassay (EIA) and confirmation with a specific immunoblot. Searching for the most sensitive and specific approach, this retrospective study evaluated standard (STTT) and modified (MTTT) strategies using a well-defined study population.MethodsCases included patients with active Lyme neuroborreliosis (LNB; n = 29) or Lyme arthritis (LA; n = 17). Controls comprised patients treated for LNB (n = 36) or LA (n = 8), healthy individuals who were either untreated (n = 75) or treated for LB (n = 15) in the past, and patients with potentially cross-reactive diseases (n = 16). Sera were subjected to three EIAs and two immunoblots. Reactive screening results were confirmed by immunoblot (STTT) or EIA (MTTT). Solitary IgM results in the screening assay and effects of antibiotic treatment on isotype-specific seropositivity rates were also assessed.ResultsSensitivities of STTT strategies ranged from 90%–97% for LNB and were 100% for LA. MTTT strategies were 100% sensitive. Specificities ranged from 89%–95% for STTT and from 88%–93% for MTTT strategies. Differences between STTT and MTTT strategies were not statistically significant. Solitary IgM reactivity was common among controls. Antibiotic treatment significantly reduced IgM/IgG positivity for LNB patients; for LA patients, a decline was only observed for IgM.ConclusionIn conclusion, MTTT strategies showed a slightly higher sensitivity and similar specificity compared to STTT strategies. Since EIAs are more time- and cost-efficient, MTTT strategies seem more favorable for clinical use. IgG testing enhances specificity with minimal sensitivity loss.

Seroprevalence of cytomegalovirus among pregnant women in Singapore

BackgroundCytomegalovirus (CMV) is the most common congenital infection in pregnancy with potential long-term adverse effects on the fetus. There is limited data on CMV seroprevalence in pregnant women in Singapore, with last reported study dating back over two decades. We look at the latest CMV seroprevalence in antenatal population in Singapore.MethodsBetween January 2021 and August 2021, 385 pregnant women receiving antenatal care at Singapore General Hospital were randomly selected for CMV IgG test to be performed on their blood samples collected during the first trimester of their pregnancies. Positivity for CMV IgG represents past exposure prior to pregnancy.ResultsOverall CMV seroprevalence was 71.7% (276/385) (95% CI 067, 0.76, p value < 0.001). The trend of CMV IgG positivity increased with age, 68.3% (95% CI 0.60, 0.76, p value < 0.001) in those aged 20–29, 72.5% (95% CI 0.66, 0.78, p value < 0.001) in the 30–39 age group, and 79.0% (95% CI 0.67, 0.76, p value 0.012) in women over 40.ConclusionsThere is a declining trend in CMV seroprevalence among pregnant women in Singapore, which indicates that a substantial portion of this population faces the risk of primary maternal CMV infection during pregnancy. Emerging research suggests that prenatal treatment with valacyclovir effectively reduces the likelihood of vertical transmission. Considering this evidence, it is imperative to reevaluate the recommendations for universal maternal CMV screening during pregnancy.

B-043 Q-nab™ Igg kit: verification and validation of a novel cell-free quantitative neutralizing antibody assay

Abstract Background As the world exits the COVID-19 pandemic era, it is very important to assess population-level and individual seroprotectivity against multiple circulating and emerging SARS-CoV-2 strains, especially in vulnerable populations. Current serological measurements for neutralizing antibodies (NAbs) are either done using complex and time-intensive pseudovirus- or micro-neutralization assays or as a high throughput competitive ELISA assay. These assays, by design, cannot be multiplexed to measure NAb titers against multiple strains and suffer from a limited dynamic range. The Q-NAb IgG Tests, which rely on blocking the non-neutralizing antibodies (NNAbs) using a novel fusion protein, were developed and validated to quantitatively measure NAb titer against the SARS-CoV-2 strains used to develop the first two mRNA vaccines viz. ancestral and BA.4/5 strains. Methods The Q-NAb assay measures the NAb titer in a sample by first sequestering the NNAbs using the fusion protein (made by covalently coupling SARS-CoV-2 BA.4/5 RBD and h-ACE2 protein) thereby enriching the NAbs in the sample. Variant-specific NAbs are then detected using an indirect ELISA where the wells are coated with the variant RBD and yield a signal that is directly proportional to the concentration of NAb. Clinical samples from subjects that have either had a SARS-CoV-2 infection (N=27), taken the initial vaccine series (N=123) and/or the bivalent booster (N=151) and pre-pandemic samples (N=29) were commercially sourced. Q-NAb NAb titers were measured using the ancestral and BA.4/5 kits and were compared against corresponding MN50 values using both parametric and non-parametric models. Single-site precision, low-end sensitivity, dilutional linearity, and interference screening of Q-NAb IgG Kits were evaluated in accordance with appropriate CLSI guidelines. Traceability and total uncertainty of the Q-NAb IgG Kits (Ancestral and BA.4/5) to WHO International Standard 21/340 and 21/338 respectively was established using a calibration hierarchy adapted from ISO 17511:2020. Results Both the ancestral and BA.4/5 Q-NAb IgG Test Kits correlated with MN50 titers with a Spearman correlation coefficient of 0.90 and 0.89 respectively. The total uncertainty in traceability of calibration to WHO International standards 21/340 and 21/338 was found to be less than 10% for both tests. Single site precision across the assay range for BA.4/5 kit was found to be 6-10% with a limit of quantitation of 312 IU/mL. Assays exhibited dilutional linearity across their respective dynamic range and had no significant interference from common endogenous and exogenous substances. Conclusions We have successfully validated the novel Q-NAb IgG neutralization assay platform as individual assays for measuring neutralizing titers against ancestral and BA.4/5 SARS-CoV-2 strains. The assays have expanded dynamic range, excellent analytical performance and correlation to accepted gold-standard microneutralization assays. Both assays are calibrated and traceable to WHO international standards, thereby enabling the compilation and comparison of data from multiple clinical cohorts run across multiple laboratories. The design of the Q-NAb IgG Test kit makes it amenable to multiplexing (for example, on an MSD platform) to assess neutralization titers against multiple variants at the same time. Such a multiplexed platform can be used to assess vaccine efficacy and seroprotection against multiple variants including emerging variants.

Exploratory study of antibody titers against SARS-CoV-2 using an indirect immunoperoxidase assay in COVID-19 patients and vaccinated volunteers

BackgroundA number of antibody test kits for detecting prior SARS-CoV-2 infection and post-immunization status have been commercialized. Indirect immunoperoxidase assay (IIP) is a conventional method to test antibodies. We evaluated the diagnostic accuracy and antibody titer profile of the IIP in COVID-19 and pre- and post-vaccination.MethodsWe conducted a hospital-based observational study in Fukushima prefecture, Japan. We enrolled COVID-19 inpatients who tested positive by PCR. We used serum samples collected > 10 years before the pandemic as the negative control. We also included volunteers vaccinated at the hospital. All participants were tested using an IIP with whole-cell antigen of the six SARS-CoV-2 variants isolated in Japan during the epidemic and an IgG ELISA kit. Negative controls and vaccinated volunteers were also tested using a lateral flow assay (LFA) kit. We conducted receiver operating characteristic (ROC) analysis to evaluate diagnostic accuracy and performed logistic regression analysis to explore factors associated with antibody titer.ResultsWe included 146 COVID-19 inpatients, 38 negative controls, and 36 vaccinated volunteers. Most participants had the highest titer for IgG and IgM in the wild type-A antigen among the six variants. The sensitivity, specificity, and accuracy of the IgG ELISA kit were 60.3%, 100%, and 68.5%; of the IIP for IgG with the cutoff titer at 1:80, 82.2%, 94.7%, and 84.8%, respectively. The ROC curves of the ELISA and IIP for IgG were almost identical. In the IgG tests of the 36 volunteers, 35 were positive for ELISA and IIP and 34 for LFA after two vaccinations. IgM titers in the IIP were < = 1:40 in 114 patients and 32 volunteers after two vaccinations; therefore, the IgM titer is unsuitable for diagnosis. In COVID-19 patients, age, days from disease onset, > = 7 days after the second vaccination, and immunosuppressants for comorbidity were associated with IgG titer of > = 1:640 in the IIP.ConclusionsThe diagnostic accuracy of the IIP for detecting IgG antibodies in COVID-19 or after two vaccinations is equivalent to that of an ELISA. Further investigations are required to address the association between antibody titers in the IIP and their protective or harmful effects against COVID-19.

Oral Chagas disease outbreak by bacaba juice ingestion: A century after Carlos Chagas' discovery, the disease is still hard to manage.

Orally transmitted acute Chagas disease (ACD) primarily affects low-visibility and low-income individuals in tropical and subtropical zones. Managing ACD remains challenging even after more than 100 years of its discovery. Its spread to non-endemic areas has made it a global health issue. The aim of this work is to demonstrate the difficulties encountered in handling a real-life situation. This report examines an outbreak of 39 cases of ACD due to oral transmission by bacaba juice ingestion that occurred in Pedro do Rosário, Maranhão, Brazil. A clinical and epidemiological investigation, including an entomological search, was conducted. Diagnosis criteria included positive peripheral blood smear (PBS), seroconversion of IgG, and a two-fold increase in IgG titer (laboratory criteria); and clinical findings, epidemiological exposure, and at least one positive IgG test (clinical-epidemiological criteria). In-house conventional polymerase chain reaction (PCR) was performed on 33 samples. All patients were treated with benznidazole. After 4.5 years, IgG levels were reassessed in 26 individuals. The mean age was 33.6 years, with no gender difference. The mean incubation period was 13.8 days, and the mean between symptom onset and treatment was 16.6 days. The most common symptoms were fever and lymphadenopathy (90%). Diagnostic success rates were 66.6% (laboratory criteria), 23% (clinical-epidemiological criteria), and 10.2% (high clinical suspicion despite negative tests). Test positivity rates were 69.7% (PBS), 91.4% (serology), and 100% (PCR). There were no deaths. Serological cure was achieved in 34.6% of cases, and IgG titers decreased in 15.3%. We encountered several barriers in managing ACD, including population vulnerability, reliance on outdated diagnostic techniques, lack of standardized molecular biology methods, and limited therapeutic options. This report underscores the importance of rapid surveillance and early treatment to prevent fatalities. We recommend the standardization of conventional PCR in diagnostic routines.

Congenital CMV infection - what we know about the symptoms, treatment and prevention? - Review of literature

Introduction: Cytomegalovirus (CMV) is a double-strand DNA virus, member of the viral family known as Herpesviridae which is wide-spread. CMV infection is the most common congenital infection worldwide. Disease is mostly asymptomatic for healthy people, therefore is detected late, when the children start presenting symptoms. Unfortunately the congenital CMV infection leads to the serious health problems for infants. Detection of the virus is typically done through quantitative PCR assays. Infection especially affects nervous system and can present infant’s deafness. Earlier it was equivalent with the children being deaf till the end of life, but nowadays thanks to the development of laryngological methods (ex. cochlear implantation) patients have chance to grow up correctly. Material and methods: A literature search was conducted using Google Scholar, PubMed, and Web of Science databases. We searched articles by entering key words in the appropriate configuration: “CMV”, “Congenital CMV infection”, “valganciclovir”, “infant’s deafness”. Scientific articles published between 1991–2023 were analyzed from all over the world and guidelines of Polish Society of Epidemiology and Infectious Diseases.Conclusions: Currently we haven’t got prevention towards congenital CMV, only the treatment for infants: valganciclovir. It stops development of severe symptoms. There are available analysis, where using valganciclovir during pregnancy reduces the possibility or soften the course of the congenital CMV infection , but it’s not the obligatory guidelines. In many countries researchers want to conduct screening test for CMV IgG among the pregnant women.

Performance Comparison of Four Hepatitis E Antibodies Detection Methods.

HEV antibody detection constitutes the main screening test for HEV infection. The aim of this study is to compare the sensitivity and specificity of four techniques: LIAISON® MUREX DiaSorin anti-HEV IgG and anti-HEV IgM assays, Hepatitis E VIRCLIA® IgM and IgG monotests, WANTAI HEV-IgM and IgG ELISA and VIDAS® anti-HEV IgM and IgG tests in five panels of samples configurated according to the immunoblot (RecomLine, Mikrogen, Neuss, Germany). Anti-HEV IgM sensitivity in the acute phase was 100% in all techniques, while sensitivity, including the immediate convalescence phase, was 96.74% for LIAISON®, 83.14% for VIRCLIA®, 84.78% for WANTAI and 88.04% for VIDAS®. Anti-HEV IgM specificity was 100% for both LIAISON® and VIRCLIA®. Anti-HEV IgM WANTAI agreed with VIRCLIA® with a good Kappa coefficient (κ = 0.71). Anti-HEV IgG post-infection sensitivity was 100% for LIAISON®, VIDAS® and VIRCLIA® and 99% for WANTAI. Anti-HEV IgG specificity reached 97.17% for LIAISON and 88.68% for VIRCLIA®. Our results demonstrated a better capacity of LIAISON® MUREX anti-HEV IgM than that of competitors for detecting acute infections as well as accurate anti-HEV IgG results and in how to resolve them.

Relation of ICAM-1 and VCAM-1 markers in COVID-19 patients in Kirkuk province.

The advent of the Coronavirus Disease 2019 (COVID-19) has presented a substantial and urgent global public health issue. Biomarkers have the potential to be utilized for the identification of endothelium and/or alveolar epithelial damage in instances of COVID-19 infection. to evaluate the levels of Intercellular adhesion molecule-1 (ICAM-1) and Vascular cell adhesion molecule (VCAM-1) biomarkers in hospitalized patients who tested positive for COVID-19 infection using Polymerase Chain Reaction (PCR) with the virus specific Immunoglobulins; IgM, and IgG testing. This can help with improved clinical management and treatment programs. A case-control study that involved 90 hospitalized patients who tested positive for COVID-19 and 40 apparently healthy control patients, subjects in both groups underwent nasopharyngeal swabs for PCR and blood sample collection for evaluation of serum; IgM, IgG, ICAM-1 and VCAM-1 levels. Males made up the vast majority of the patients (78.9%), with only a minor percentage of females (21.1%) P value 0.1641. Furthermore, every patient in this study had a minimum of one risk factor for COVID-19. The investigator's results show that COVID-19 patients had higher amounts of endothelial cell adhesion indicators (ICAM-1 and VCAM-1) with mean values of 126.27 ± 89.51 ng/mL and 109.74 ± 96.57 ng/mL respectively. While, ICAM-1 and VCAM-1, were present at normal levels in the control group with difference P value 0.0028 and 0.0032 in comparison to the patient's group respectively. The adhesive markers ICAM and VCAM play a crucial role in the development of COVID-19 and the strong endothelial activation and dysfunction linked to both acute and persistent immunological responses is shown by the substantial correlation found in COVID-19 patients between the presence of IgM and IgG antibodies and higher levels of ICAM-1 and VCAM-1.

Inclusive ABO-Incompatible Listing for Pediatric Heart Transplantation Results in Comparable Post-Transplant Rejection-Free Survival in a Single-Center Series.

ABO-incompatible (ABOi) heart transplantation (HT) has increased organ availability for infants with end-stage heart failure. Despite increasing adoption of ABOi listing for HT, data remain limited regarding pre- and post-HT immunologic profiles to guide listing practices and post-HT follow-up. Thus, the purpose of this study was to evaluate post-HT outcomes at a single center employing inclusive ABOi listing irrespective of pre-HT isohemagglutinin titers. All HT recipients listed at less than 24months of age at our institution from 2010-2020 were included. Pre- and post-operative variables were compared for ABOi and ABO-compatible (ABOc) recipients. Separate iso-IgG and iso-IgM titers were monitored pre- and post-HT. Primary outcomes were compared between ABOi versus ABOc groups at mid-term follow-up. 51 HTs were performed on 50 patients from 2010-2020 (ABOi, N = 13; ABOc, N = 38). Six ABOi recipients received intra-operative plasma exchange for elevated titers (greater than 1:8 for IgG or IgM or reverse type greater than 2 +). Treated rejection, DSA, CAV, primary graft failure, need for re-HT, and survival were comparable between ABOi and ABOc groups at mid-term follow-up. An inclusive approach to ABOi HT listing for infants less than 24months of age results in comparable post-transplant rejection-free survival, CAV, and prevalence of DSA at mid-term follow-up. These data define a potential role for specific IgM and IgG testing to promote understanding of risk stratification in pediatric ABOi listing, and support an inclusive strategy irrespective of high pre-HT titers to expand the number of available donor hearts for infants and older children awaiting HT.

Pepsinogen and Helicobacter pylori: Serum biomarkers for gastric cancer risk in a diverse United States population

BackgroundSerum Pepsinogen (PG) and Helicobacter pylori (Hp) have potential as biomarkers to identify persons at high risk for gastric cancer (GC) in low incidence populations. We explored the use of these biomarkers in a diverse US population. MethodsSingle institution study using serum samples from 32 newly diagnosed GC (before treatment) and 60 non-cancer participants. ELISA-based PG-I, PG-II, Hp IgG, and Hp virulence seromarker (CagA, VacA) tests were conducted to examine differences between GC and non-GC participants. ResultsMedian age was 58 (IQR 48–68); 56 % were females; 30.1 % were white, 14.8 % black, 28.7 % Hispanic, 6.1 % Asian and 18.2 % other/unknown race/ethnicity. Median values of Hp (47.9 vs 12.6 U/mL, p = 0.003) and pepsinogen ratio (PGR=PGI/PGII) (4.0 vs 7.5, p = 0.003) differed between GC and non-GC. Performance of pepsinogen tests using “standard” cut-offs (PGI ≤ 70 ng/mL and PGR ≤ 3) were highly specific (91.7 %), but not sensitive (34.4 %), while Hp IgG test using “standard” cut-off (≥ 30 U/mL) was sensitive (78.8 %), but less specific (41.2 %). Optimized cut-off values identified in our population using Youden’s Index were PGR ≤ 5.2 and Hp ≥ 17.5 U/mL. Using a combination of these values resulted in a significant increase in test sensitivity (87.9 %) with lower specificity (50.8 %). ConclusionThe combination of pepsinogens and Hp show promise as biomarkers of GC risk in a racially and ethnically diverse US population. Optimal biomarker cut-off points for US populations may differ from those established in East Asia. By adjusting cut-offs there is potential to design GC risk stratification tools tailored specifically for the diverse population within the US.

Prevalence and Incidence of Hepatitis E Infection in China

Background and aimsChina is an endemic area for HEV infection. Estimating the prevalence and incidence of HEV infection in China plays a pivotal role in informing public health policies to prevent and control hepatitis E. This study aimed to investigate the prevalence of anti-HEV IgG and incidence of HEV seroconversion in China. MethodsThis study was based on the Meinian health check-up database in China. Participants who underwent testing for anti-HEV IgG at check-up centers in 24 provinces between 2017 and 2022 were included. In the cross-sectional analyses, overall prevalence and stratified prevalence in subpopulations with various characteristics were estimated and standardized according to the 2020 census of the Chinese population. In the longitudinal analyses, the occurrence of anti-HEV IgG positivity during the follow-up was defined as an incident HEV seroconversion. Overall and stratified incidence rates were estimated and expressed as per 100 person-years. Poisson regression was used to explore risk factors associated with HEV seroconversion. Results85,238 and 11,154 participants were included in the cross-sectional and longitudinal analyses, respectively. The prevalence of anti-HEV IgG in the general population was 18.02%. During a median follow-up of 1.2 years, the incidence rate of HEV seroconversion was 1.79 per 100 person-years. Age ≥ 60 years, low socioeconomic status, living in coastal areas, living in areas with high drainage density, and living in areas with high anti-HEV IgG prevalence were independent risk factors for HEV seroconversion. ConclusionsOur findings would help inform policy making for hepatitis E prevention and control in China, as well as in other endemic regions of the world.