Havlicková Martina, Jirincová Helena, Maresová Vilma, Dzupová Olga, Limberková Radomíra
Státní zdravotní ústav, Centrum epidemiologie a mikrobiologie, Praha.
Epidemiol Mikrobiol Imunol. 2012 May;61(1-2):9-14.
Serology plays an important role in the diagnosis of influenza, particularly in the detection of post-vaccination and post-infection antibodies. When considering the range of diagnostic options, the serological method should be selected depending on the circumstances - whether single or paired serum samples are tested, whether adequate patient medical history data are available, whether epidemiological links are suspected, and, in particular, to what purpose the result will be used (differential diagnosis, post-infection follow-up, post-vaccination monitoring, etc.). The virus neutralization assay is one of the most sensitive and most objective serological tests, but it is highly dependent on the reaction balance and quality of the virus used. Determining the protective titer is crucial for the routine practice. Based on our experiments, we concluded that the virus neutralizing antibody titers are up to eight times as high in comparison with the hemaglutination inhibition test (HIT) or complement fixation reaction (CFR), but the correlation varies and is significantly influenced by interindividual variation in anti-neuraminidase antibodies and those against some internal proteins of influenza virus. We assume that the protective titer in the virus neutralization assay will be not less than 1:80. The predictive value of the titers below 1:40 is questionable.
血清学在流感诊断中起着重要作用，尤其是在检测疫苗接种后和感染后的抗体方面。在考虑一系列诊断选项时，应根据具体情况选择血清学方法，例如是否检测单份或双份血清样本、是否有足够的患者病史数据、是否怀疑存在流行病学关联，特别是检测结果将用于何种目的（鉴别诊断、感染后随访、疫苗接种后监测等）。病毒中和试验是最敏感、最客观的血清学检测方法之一，但它高度依赖于反应平衡和所用病毒的质量。确定保护性滴度对常规实践至关重要。基于我们的实验，我们得出结论，与血凝抑制试验（HIT）或补体结合反应（CFR）相比，病毒中和抗体滴度高达八倍，但相关性有所不同，并且受到抗神经氨酸酶抗体以及针对流感病毒某些内部蛋白的抗体个体差异的显著影响。我们假设病毒中和试验中的保护性滴度将不低于1:80。低于1:40的滴度的预测价值值得怀疑。
