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Published on: April 10, 2018
Sensitivity and specificity of three ELISA-based assays for discriminating primary from secondary acute dengue virus
Vanda Akico Ueda Fick de Souza1, Adriana Fumie Tateno, Renato Reis Oliveira
1Laboratório de Virologia (LIM-HC)--Instituto de Medicina Tropical de São Paulo e Departamento de Moléstias Infecciosas e Parasitárias da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Background:
Discrimination between primary and secondary dengue virus infection traditionally has been performed using the hemagglutination inhibition (HI) test. However, this test has practical limitations and disadvantages.
Objective:
To evaluate the ability of three ELISA-based methods (IgG avidity test, IgM/IgG ratio and IgG titer) to discriminate primary from secondary dengue infection.
Study Design:
Serum samples from convalescent-phase patients with confirmed acute, primary (n=46) or secondary (n=33) dengue virus infection were tested using three ELISA-based methods. A ROC curve was employed to establish the cut-off points and to evaluate the ability of the three methods to distinguish between acute, primary and secondary dengue virus infection.
Results:
All three assays exhibited sensitivity and negative predictive values of 100% for defining secondary infection. The specificity and positive predictive values were respectively 97.8% and 93.7% for the IgG avidity test, 95.7% and 88.2% for the IgM/IgG ratio assays, and 97.8% and 93.7% for the IgG titer assay.
Conclusion:
All three ELISA-based assays proved reliable tools for discriminating between acute, primary and secondary dengue virus infection when using serum samples from convalescent-phase patients.
