de Souza Vanda Akico Ueda Fick, Tateno Adriana Fumie, Oliveira Renato Reis, Domingues Renan B, Araújo Evaldo Stanislau, Kuster Gustavo W, Pannuti Cláudio Sérgio
Laboratório 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.
J Clin Virol. 2007 Jul;39(3):230-3. doi: 10.1016/j.jcv.2007.04.005. Epub 2007 May 16.
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.
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.
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.
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.
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.
传统上，原发性和继发性登革热病毒感染的鉴别是通过血凝抑制（HI）试验进行的。然而，该试验存在实际局限性和缺点。
评估三种基于酶联免疫吸附测定（ELISA）的方法（IgG亲和力试验、IgM/IgG比值和IgG滴度）区分原发性和继发性登革热感染的能力。
使用三种基于ELISA的方法对确诊为急性原发性（n = 46）或继发性（n = 33）登革热病毒感染的恢复期患者的血清样本进行检测。采用受试者工作特征（ROC）曲线确定临界值，并评估这三种方法区分急性、原发性和继发性登革热病毒感染的能力。
在定义继发性感染方面，所有三种检测方法的敏感性和阴性预测值均为100%。IgG亲和力试验的特异性和阳性预测值分别为97.8%和93.7%，IgM/IgG比值检测分别为95.7%和88.2%，IgG滴度检测分别为97.8%和93.7%。
当使用恢复期患者的血清样本时，所有三种基于ELISA的检测方法都被证明是区分急性、原发性和继发性登革热病毒感染的可靠工具。
