Lima Monique da Rocha Queiroz, de Lima Raquel Curtinhas, de Azeredo Elzinandes Leal, Dos Santos Flavia Barreto
Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro 21040-900, Brazil.
Diagnostics (Basel). 2021 Apr 30;11(5):819. doi: 10.3390/diagnostics11050819.
In Brazil, chikungunya emerged in 2014, and by 2016, co-circulated with other arbovirosis, such as dengue and zika. ELISAs (Enzyme-Linked Immunosorbent Assays) are the most widely used approach for arboviruses diagnosis. However, some limitations include antibody cross reactivities when viruses belong to the same genus, and sensitivity variations in distinct epidemiological scenarios. As chikungunya virus (CHIKV) is an alphavirus, no serological cross reactivity with dengue virus (DENV) should be observed. Here, we evaluated a routinely used chikungunya commercial IgM (Immunoglobulin M) ELISA test (Anti-Chikungunya IgM ELISA, Euroimmun) to assess its performance in confirming chikungunya in a dengue endemic area. Samples ( = 340) representative of all four DENV serotypes, healthy individuals and controls were tested. The Anti-CHIKV IgM ELISA test had a sensitivity of 100% and a specificity of 25.3% due to the cross reactivities observed with dengue. In dengue acute cases, the chikungunya test showed an overall cross-reactivity of 31.6%, with a higher cross-reactivity with DENV-4. In dengue IgM positive cases, the assay showed a cross-reactivity of 46.7%. Serological diagnosis may be challenging and, despite the results observed here, more evaluations shall be performed. Because distinct arboviruses co-circulate in Brazil, reliable diagnostic tools are essential for disease surveillance and patient management.
在巴西，基孔肯雅热于2014年出现，到2016年，它与登革热和寨卡等其他虫媒病毒共同传播。酶联免疫吸附测定（ELISA）是虫媒病毒诊断中使用最广泛的方法。然而，一些局限性包括当病毒属于同一属时抗体的交叉反应性，以及在不同流行病学情况下的敏感性差异。由于基孔肯雅病毒（CHIKV）是一种甲病毒，因此不应观察到与登革热病毒（DENV）的血清学交叉反应。在此，我们评估了一种常用的基孔肯雅热商业IgM（免疫球蛋白M）ELISA检测方法（抗基孔肯雅热IgM ELISA，欧蒙公司），以评估其在登革热流行地区确诊基孔肯雅热的性能。对代表所有四种登革热病毒血清型的样本（n = 340）、健康个体和对照进行了检测。由于观察到与登革热的交叉反应性，抗CHIKV IgM ELISA检测的敏感性为100%，特异性为25.3%。在登革热急性病例中，基孔肯雅热检测显示总体交叉反应性为31.6%，与DENV-4的交叉反应性更高。在登革热IgM阳性病例中，该检测显示交叉反应性为46.7%。血清学诊断可能具有挑战性，尽管在此观察到了结果，但仍需进行更多评估。由于不同的虫媒病毒在巴西共同传播，可靠的诊断工具对于疾病监测和患者管理至关重要。
