解读罗河病毒和巴尔马森林病毒病的配对血清学。
Interpreting paired serology for Ross River virus and Barmah Forest virus diseases.
机构信息
MBBS (Hons), FRACGP, MHA, FRACMA, MACRRM, Medical Director of the United Nations@ Medical Service Division, New York, NY, USA.
BA (Hons), MA, PhD, Group Leader, Inflammation Biology Laboratory, Division of Infectious Diseases and Immunology, QIMR Berghofer Medical Research Institute, Brisbane, Qld.
出版信息
Aust J Gen Pract. 2019 Sep;48(9):645-649. doi: 10.31128/AJGP-02-19-4845.
BACKGROUND
Ross River virus (RRV) and Barmah Forest virus (BFV) cause approximately 4000 and 1000 cases, respectively, of rheumatic disease in Australia every year. Confirmation of a diagnosis usually involves testing for virus-specific immunoglobulin (Ig) M and IgG by a National Association of Testing Authorities-accredited pathology facility.
OBJECTIVE
The aim of the article is to provide a logical framework by which clinicians can interpret paired RRV and BFV serology results in environments in which numerical antibody titres are no longer routinely provided. The traditional recommendation to look for an increase in titres is now largely obsolete.
DISCUSSION
Paired serology is clinical best practice but needs to be appropriately interpreted given the false positive and negative rates, the large number of asymptomatic infections and the long-term persistence of IgM in some individuals. An inappropriate interpretation risks a misdiagnosis.
背景
罗斯河病毒（RRV）和班达森林病毒（BFV）每年分别导致澳大利亚约 4000 例和 1000 例风湿性疾病。诊断的确认通常涉及由国家测试机构认可的病理实验室检测病毒特异性免疫球蛋白（Ig）M 和 IgG。
目的
本文旨在提供一个逻辑框架，临床医生可以根据该框架在不再常规提供数值抗体滴度的环境中解释配对的 RRV 和 BFV 血清学结果。现在，传统的寻找滴度增加的建议已经基本过时。
讨论
配对血清学是临床最佳实践，但需要根据假阳性和假阴性率、大量无症状感染以及某些个体中 IgM 的长期持续存在进行适当解释。不适当的解释会导致误诊的风险。
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