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- Title
Prolonged persistence of IgM against dengue virus detected by commonly used commercial assays.
- Authors
Yu-Wen Chien; Zi-Hu Liu; Fan-Chen Tseng; Tzu-Chuan Ho; How-Ran Guo; Nai-Ying Ko; Wen-Chien Ko; Guey Chuen Perng; Chien, Yu-Wen; Liu, Zi-Hu; Tseng, Fan-Chen; Ho, Tzu-Chuan; Guo, How-Ran; Ko, Nai-Ying; Ko, Wen-Chien; Perng, Guey Chuen
- Abstract
<bold>Background: </bold>Initial symptoms of dengue fever are non-specific, and thus definite diagnosis requires laboratory confirmation. Detection of IgM against dengue virus (DENV) has become widely used for dengue diagnosis. Understanding the persistence of anti-DENV IgM in subjects after acute infection is essential in order to interpret test results correctly. Although the longevity of anti-DENV IgM has been vehemently investigated in symptomatic children, anti-DENV IgM persistence in adults and in asymptomatically infected people have seldom been reported.<bold>Methods: </bold>We prospectively investigated 44 adults with detectable anti-DENV IgM in a serosurvey conducted in the 2015 dengue epidemic in Tainan, Taiwan. Among subjects within the cohort, 17 were classified to be symptomatic and 27 were asymptomatic. The enzyme-linked immunosorbent assay (ELISA) from Standard Diagnostic (SD) and Focus Diagnostic were used to detect anti-DENV IgM for specimens collected initially, at 6 and 12 months. Regression analyses were used to estimate the duration of anti-DENV IgM fell below the detectable level. Rapid dengue tests from Standard Diagnostics had been widely adopted to detect anti-DENV IgM in Taiwan during the 2015 dengue outbreak. As such, collected specimens were also evaluated with the SD rapid dengue test in parallel.<bold>Results: </bold>Anti-DENV IgM was detectable in 70.5 and 46.2% of the 44 subjects at 6 months and 12 months by the SD ELISA, respectively, while 13.6 and 7.7%, respectively, by the Focus ELISA. There was no significant difference in anti-DENV IgM detection for the follow-up specimens between subjects with symptomatic and asymptomatic infections. The regression analysis estimated that anti-DENV IgM persistence fell to the undetectable level at 338.3 days (95% CI 279.7-446.9) by SD ELISA, while at 175.7 days (95% CI 121.9-221.1) by Focus ELISA. The detectable frequency of anti-DENV IgM by rapid tests was 86.4%, 68.2 and 35.9% at initial, 6 and 12 months, respectively.<bold>Conclusion: </bold>Anti-DENV IgM was found to persist much longer than previously thought, suggesting a necessity of re-evaluation of the use of anti-DENV IgM for both the diagnosis of dengue and serological surveillance, especially when large outbreaks have occurred in the preceding year.
- Subjects
TAIWAN; IMMUNOGLOBULIN analysis; BUSINESS; COMPARATIVE studies; DENGUE; DIAGNOSTIC reagents &; test kits; ENZYME-linked immunosorbent assay; FLAVIVIRUSES; IMMUNOGLOBULINS; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PROTEINS; RESEARCH; SERODIAGNOSIS; VIRAL antibodies; EVALUATION research; DIAGNOSIS
- Publication
BMC Infectious Diseases, 2018, Vol 18, Issue 1, p1
- ISSN
1471-2334
- Publication type
journal article
- DOI
10.1186/s12879-018-3058-0