Ahmed Nishat Hussain, Broor Shobha
Department of Microbiology, SGT Medical College-Hospital and Research Institute, Gurgaon, India.
J Vector Borne Dis. 2014 Sep;51(3):194-9.
BACKGROUND & OBJECTIVES: Diagnosis of dengue infection in acute phase is important for clinical care, implementing control measures, surveillance and research. Currently, dengue fever is diagnosed by means of virus isolation, reverse transcriptase PCR or IgM and IgG based ELISA. Given the limitations of all the existing diagnostic methods, there is a need for rapid, sensitive and high throughput methods for detection of dengue virus in early stages of the disease. The study was conducted with the objectives to evaluate a dengue virus NS1 antigen detection ELISA and a TaqMan based real time RT-PCR for detection of all four serotypes of dengue virus, as diagnostic tools for acute dengue virus infection.
The acute phase serum samples of patients (n=153) presenting with dengue fever were subjected to NS1 antigen detection and real time RT-PCR. The results were compared to those of virus isolation in the C6/36 cell lines (n=55).
The efficiency, sensitivity, specificity, positive and negative predictive values of NS1 Ag detection ELISA were 83.6, 73.5, 100, 100 and 70% respectively while for real time RT-PCR these were 87.3, 79.4, 100, 100 and 75% respectively. Maximum sensitivity of NS1 antigen detection ELISA was seen in two days of fever and that of real time RT-PCR in three days of fever.
INTERPRETATION & CONCLUSION: NS1 antigen detection ELISA and real time RT-PCR were found to be rapid, convenient and efficient tests for diagnosing of dengue fever in acute phase and the diagnosis could be made as early as within three days of onset of fever.
登革热感染急性期的诊断对于临床治疗、实施防控措施、监测及研究都很重要。目前，登革热通过病毒分离、逆转录聚合酶链反应（RT-PCR）或基于免疫球蛋白M（IgM）和免疫球蛋白G（IgG）的酶联免疫吸附测定（ELISA）来诊断。鉴于所有现有诊断方法都存在局限性，需要快速、灵敏且高通量的方法来在疾病早期检测登革病毒。本研究旨在评估一种登革病毒非结构蛋白1（NS1）抗原检测ELISA和一种基于TaqMan的实时RT-PCR，用于检测登革病毒的所有四种血清型，作为急性登革病毒感染的诊断工具。
对153例登革热患者的急性期血清样本进行NS1抗原检测和实时RT-PCR检测。将结果与在C6/36细胞系中进行病毒分离的结果（n = 55）进行比较。
NS1抗原检测ELISA的效率、灵敏度、特异性、阳性预测值和阴性预测值分别为83.6%、73.5%、100%、100%和70%，而实时RT-PCR的这些指标分别为87.3%、79.4%、100%、100%和75%。NS1抗原检测ELISA在发热两天时灵敏度最高，实时RT-PCR在发热三天时灵敏度最高。
NS1抗原检测ELISA和实时RT-PCR被发现是诊断登革热急性期快速、便捷且高效的检测方法，发热三天内即可做出诊断。
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