Detection of the dengue virus NS1 antigen using an enzyme immunoassay

Current diagnostic methods for dengue virus (DV) rely primarily on detection of anti-DV antibodies and/or DV RNA by reverse transcriptase (RT) PCR. Several limitations exist however: seroconversion is delayed following infection, and DV RT-PCR assays are not yet readily available. The DV nonstructural protein 1 (NS1) antigen is an alternative acute phase DV biomarker, and here, we evaluated the new InBios (InBios International, Inc., Seattle, WA, USA) DENV Detect(TM) NS1 enzyme-linked immunoassay (ELISA) compared to DV RT-PCR and serology for detection of recent DV infection. We report a positive, negative, and overall percent agreement of 96% (24/25), 86.0% (43/50), and 89.3% (67/75) for the InBios NS1 ELISA compared to DV RT-PCR. Performance of the NS1 ELISA compared to serology for anti-DV IgM antibodies showed a positive, negative, and overall percent agreement of 78.0% (85/109), 90.7% (333/367), and 87.8% (418/476), respectively. Collectively, the InBios NS1 ELISA can be used as an alternative to DV RT-PCR for identification of acute DV infection.