Kashyap Rajpal Singh, Morey Shweta H, Ramteke Sonali S, Chandak Nitin H, Parida Manmohan, Deshpande Poonam S, Purohit Hemant J, Taori Girdhar M, Daginawala Hatim F
Biochemistry Research Laboratory, Central India Institute of Medical Sciences, 88/2, Bajaj Nagar, Nagpur 440010, India.
Clin Vaccine Immunol. 2010 Feb;17(2):291-7. doi: 10.1128/CVI.00326-09. Epub 2009 Dec 9.
A Chikungunya virus (CHIKV) outbreak continues in India. Monitoring of the clinical features of CHIKV infection is an important component of assessing the disease process. Diagnosis is usually made by an immunoglobulin M (IgM)/IgG enzyme-linked immunosorbent assay (ELISA). However, these assays have extremely low sensitivities for the detection of infection in the majority of CHIKV patients during the acute stage of infection (during the 1 to 4 days after infection). In our laboratory, a sensitive ELISA protocol for antigen detection has been developed for the detection of CHIKV infection in the acute stage, and in the present study we assessed the usefulness of this ELISA-based system for the detection of CHIKV infection. We performed a prospective, double-blinded study of 205 Indian patients with suspected CHIKV infection in the Nagpur District. All patients underwent a full clinical assessment, and their serum samples were analyzed for the presence of antigens and of IgM and IgG by an ELISA protocol. In patients with CHIKV infection, the sensitivity of antigen detection was 85%, which was significantly higher (P < 0.001) than that of IgM (17%) or IgG (45%) detection. The sensitivity of IgM (20%) or IgG (25%) detection was significantly lower than that of the antigen assay (95%) for patients with acute infections (i.e., from day 1 to day 5 after infection). Antigen detection not only gives a positive confirmatory result in the early phase of the disease, but it is also useful in the prodromal and subclinical stage and may be useful for field applications for the rapid detection of CHIKV infection.
基孔肯雅病毒（CHIKV）在印度的疫情仍在持续。监测CHIKV感染的临床特征是评估疾病进程的重要组成部分。诊断通常通过免疫球蛋白M（IgM）/IgG酶联免疫吸附测定（ELISA）进行。然而，这些检测方法在大多数CHIKV感染患者的急性期（感染后1至4天）检测感染的灵敏度极低。在我们实验室，已开发出一种用于急性期CHIKV感染检测的灵敏的抗原检测ELISA方案，在本研究中，我们评估了这种基于ELISA的系统在检测CHIKV感染方面的实用性。我们对那格浦尔地区205名疑似CHIKV感染的印度患者进行了一项前瞻性双盲研究。所有患者均接受了全面的临床评估，并通过ELISA方案对其血清样本进行抗原、IgM和IgG检测。在CHIKV感染患者中，抗原检测的灵敏度为85%，显著高于IgM（17%）或IgG（45%）检测的灵敏度（P<0.001）。对于急性感染患者（即感染后第1天至第5天），IgM（20%）或IgG（25%）检测的灵敏度显著低于抗原检测（95%）。抗原检测不仅在疾病早期能给出阳性确诊结果，在前驱期和亚临床阶段也很有用，可能对CHIKV感染的快速现场检测有帮助。
