Felix Alvina Clara, Romano Camila Malta, Centrone Cristiane de Campos, Rodrigues Célia Lima, Villas-Boas Lucy, Araújo Evaldo Stanislau, de Matos Andréia Manso, Carvalho Karina Inácio, Martelli Celina Maria Turchi, Kallas Esper Georges, Pannuti Claúdio Sérgio, Levi José Eduardo
Instituto de Medicina Tropical de São Paulo e Departamento de Moléstias Infecciosas e Parasitárias da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Clin Vaccine Immunol. 2012 Dec;19(12):1972-6. doi: 10.1128/CVI.00535-12. Epub 2012 Oct 24.
In 2010, a large outbreak of dengue occurred in Santos, Brazil. The detection of the NS1 antigen was used for diagnosis in addition to the detection of IgG, IgM, and RNA. A large number of NS1 false-negative results were obtained. A total of 379 RNA-positive samples were selected for thorough evaluation. NS1 was reactive in 37.7% of cases. Most of the cases were characterized as a secondary infection by dengue 2 virus. Sequencing of NS1 positive and negative isolates did not reveal any mutation that could justify the diagnostic failure. Use of existing NS1 tests in the Brazilian population may present a low negative predictive value, and they should be used with caution, preferentially after performing a validation with samples freshly obtained during the ongoing epidemic.
2010年,巴西桑托斯发生了大规模登革热疫情。除检测IgG、IgM和RNA外,还使用NS1抗原检测进行诊断。结果获得了大量NS1假阴性结果。总共选择了379份RNA阳性样本进行全面评估。NS1在37.7%的病例中呈反应性。大多数病例被鉴定为登革2型病毒继发感染。对NS1阳性和阴性分离株进行测序未发现任何可解释诊断失败的突变。在巴西人群中使用现有的NS1检测可能具有较低的阴性预测值,应谨慎使用,最好在对当前疫情期间新采集的样本进行验证后再使用。