基孔肯雅热病毒 RNA、免疫球蛋白-M 和 G 抗体的动力学。
Kinetics of viral RNA, immunoglobulin-M & G antibodies in Kyasanur forest disease.
机构信息
Maximum Containment Laboratory, ICMR-National Institute of Virology, Pune, Maharashtra, India.
Epidemiology Group, ICMR-National Institute of Virology, Pune, Maharashtra, India.
出版信息
Indian J Med Res. 2019 Aug;150(2):186-193. doi: 10.4103/ijmr.IJMR_1929_17.
BACKGROUND & OBJECTIVES: Kyasanur forest disease (KFD) is an infectious disease discovered in Karnataka State of India in 1957; since then, the State has been known to be enzootic for KFD. In the last few years, its presence was observed in the adjoining five States of the Western Ghats of India. The present study was conducted to understand the kinetics of viral RNA, immunoglobulin M (IgM) and IgG antibody in KFD-infected humans for developing a diagnostic algorithm for KFD.
METHODS
A prospective follow up study was performed among KFD patients in Sindhudurg district of Maharashtra State, India. A total of 1046 suspected patients were tested, and 72 KFD patients were enrolled and followed for 17 months (January 2016 to May 2017). Serum samples of KFD patients were screened for viral RNA, and IgM and IgG antibodies.
RESULTS
KFD viral positivity was observed from 1 to 18 post-onset day (POD). Positivity of anti-KFD virus (KFDV) IgM antibodies was detected from 4 till 122 POD and anti-KFDV IgG antibodies detected from 5 till 474 POD. A prediction probability was determined from statistical analysis using the generalized additive model in R-software to support the laboratory findings regarding viral kinetics.
INTERPRETATION & CONCLUSIONS: This study demonstrated the presence of KFD viral RNA till 18 POD, IgM antibodies till 122 POD and IgG till the last sample collected. Based on our study an algorithm was recommended for accurate laboratory diagnosis of KFDV infection. A sample collected between 1 and 3 POD can be tested using KFDV real-time reverse transcriptase polymerase chain reaction (RT-PCR); between 4 and 24 POD, the combination of real-time RT-PCR and anti-KFDV IgM enzyme-linked immunosorbent assay (ELISA) tests can be used; between POD 25 and 132, anti-KFDV IgM and IgG ELISA are recommended.
背景与目的
基孔肯雅热（KFD）是 1957 年在印度卡纳塔克邦发现的一种传染病；此后，该邦被认为是 KFD 的地方性疾病。在过去的几年中，该疾病在印度西高止山脉的五个毗邻邦也有出现。本研究旨在了解 KFD 感染患者体内病毒 RNA、免疫球蛋白 M（IgM）和 IgG 抗体的动力学，以便为 KFD 开发一种诊断算法。
方法
在印度马哈拉施特拉邦辛杜杜鲁区对 KFD 患者进行了一项前瞻性随访研究。共检测了 1046 例疑似患者，纳入并随访了 72 例 KFD 患者，随访时间为 17 个月（2016 年 1 月至 2017 年 5 月）。对 KFD 患者的血清样本进行了病毒 RNA、IgM 和 IgG 抗体的筛查。
结果
在发病后第 1 天至第 18 天检测到 KFD 病毒阳性。在发病后第 4 天至第 122 天检测到抗 KFD 病毒（KFDV）IgM 抗体，在发病后第 5 天至第 474 天检测到抗 KFDV IgG 抗体。使用 R 软件中的广义加性模型进行统计分析，确定了预测概率，以支持实验室关于病毒动力学的研究结果。
解释与结论
本研究表明，在发病后第 18 天可检测到 KFD 病毒 RNA，在发病后第 122 天可检测到 IgM 抗体，在最后一次采集的样本中可检测到 IgG 抗体。基于我们的研究，建议使用该算法进行 KFDV 感染的准确实验室诊断。在发病后第 1 天至第 3 天之间采集的样本可以使用 KFDV 实时逆转录酶聚合酶链反应（RT-PCR）进行检测；在发病后第 4 天至第 24 天之间，可以使用实时 RT-PCR 和抗 KFDV IgM 酶联免疫吸附测定（ELISA）检测组合进行检测；在发病后第 25 天至第 132 天之间，推荐使用抗 KFDV IgM 和 IgG ELISA 进行检测。
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