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Published on: September 10, 2018
Performance evaluation of antibody tests for detecting infant respiratory syncytial virus infection
Samadhan J Jadhao1, Binh Ha1, Courtney McCracken1
1Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Insights
This study assessed enzyme-linked immunoassays (EIAs) for detecting respiratory syncytial virus (RSV) infection in infants. Lysate and F protein EIAs accurately identified prior RSV infection, while G protein EIAs helped determine the infecting RSV group.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- Respiratory syncytial virus (RSV) is a significant cause of respiratory illness in children and adults, with infant infections linked to later asthma development.
- Accurate detection of early infant RSV infection is crucial for understanding its long-term respiratory health impacts.
Purpose of the Study:
- To evaluate the performance of an RSV antibody enzyme-linked immunoassay (EIA) for identifying prior infant RSV infection.
- To compare the diagnostic accuracy of different RSV antibody EIAs, including lysate, F protein, and G protein (Ga and Gb) based assays.
Main Methods:
- A prospective birth cohort study involved biweekly respiratory illness surveillance and RSV polymerase chain reaction (PCR) testing in infants' first RSV season.
- Serum RSV antibodies were measured post-season using RSV A and B lysate EIAs, and compared with F, Ga, and Gb protein antibody EIAs in a subset.
- Performance was assessed by comparing EIA results with PCR-confirmed RSV infection status.
Main Results:
- The lysate EIA demonstrated high sensitivity, detecting RSV antibodies in 96% of PCR-positive infants.
- In a subset, both lysate and F protein EIAs showed 99% sensitivity for detecting RSV infection.
- G protein EIAs correctly identified the infecting RSV group in 86% of cases.
Conclusions:
- RSV lysate and F protein EIAs are highly sensitive tools for detecting infant RSV infection.
- RSV G protein EIAs can effectively indicate the specific group (A or B) of a primary RSV infection in infants.
Abstract:
Respiratory syncytial virus (RSV) infection is a major cause of respiratory tract disease in young children and throughout life. Infant infection is also associated with later respiratory morbidity including asthma. With a prospective birth cohort study of RSV and asthma, we evaluated the performance of an RSV antibody enzyme-linked immunoassay (EIA) for detecting prior infant RSV infection. Infant RSV infection was determined by biweekly respiratory illness surveillance plus RSV polymerase chain reaction (PCR) testing in their first RSV season and serum RSV antibodies after the season at approximately 1 year of age. RSV antibodies were detected by RSV A and B lysate EIA. Antibody and PCR results on 1707 children included 327 RSV PCR positive (PCR+) and 1380 not RSV+. Of 327 PCR+ children, 314 (96%) were lysate EIA positive and 583 out of 1380 (42%) children not PCR+ were positive. We compared the lysate EIA to RSV F, group A G (Ga), and group B G (Gb) protein antibody EIAs in a subset of 226 sera, 118 PCR+ children (97 group A and 21 group B) and 108 not PCR+. In this subset, 117 out of 118 (99%) RSV PCR+ children were positive by both the F and lysate EIAs and 103 out of 118 (87%) were positive by the Ga and/or Gb EIAs. Comparison of the two G EIAs indicated the infecting group correctly in 100 out of 118 (86%) and incorrectly in 1 out of 118 (1%). The lysate and F EIAs are sensitive for detecting infant infection and the two G EIAs can indicate the group of an earlier primary infection.
