Tandel Kundan, Kumar Mahadevan, Bhalla G S, Shergill S P S, Swarnim Vijaya, Sahai Kavita, Gupta R M
Associate Professor (Microbiology), Command Hospital (Central Command), Lucknow, India.
Professor (Microbiology), Bharati Vidyapeeth University Medical College, Pune, India.
Med J Armed Forces India. 2022 Jul;78(3):333-338. doi: 10.1016/j.mjafi.2021.09.001. Epub 2021 Oct 29.
All four dengue serotypes cause infection, with one of them predominantly reported from a particular geographical region. Coinfection by more than one serotype is reported from hyperendemic regions. These coinfections are clinically more severe than infection with a single serotype. This study was carried out to detect the predominant dengue serotype and presence of coinfections.
Acute-phase serum samples of patients suffering from dengue infection were collected. They were screened for the presence of IgM, IgG and NS1Ag by a rapid test. Conventional multiplex reverse transcriptase polymerase chain reaction (RT-PCR) and multiplex real-time RT-PCR assays were carried out for detection and serotyping of the dengue virus.
A total of 196 samples were positive by the rapid card test. Of these, 139 were NS1Ag positive, 40 were positive only for IgM, 5 were positive only for IgG and 12 samples were positive for different combinations of antigen and antibodies. All four serotypes were detected in these samples by PCR. DENV-3 was found to be most common circulating serotype. A total of 22 cases were found to have coinfection with more than one dengue serotypes. Samples having only antibodies and no antigen on rapid card test were also positive for virus by PCR.
Prevalence of dengue co-infections is increasing. Moreover, it is important to screen for dengue virus in those samples also which do not show NS1Ag on rapid tests and have either one or both the antibodies. Real-time multiplex RT-PCR is found to be more sensitive in detecting coinfection than conventional multiplex RT-PCR.
所有四种登革热血清型均可引起感染，其中一种血清型主要在特定地理区域被报道。在高度流行地区有超过一种血清型共同感染的报道。这些共同感染在临床上比单一血清型感染更为严重。本研究旨在检测主要的登革热血清型及共同感染的存在情况。
收集登革热感染患者的急性期血清样本。通过快速检测筛选其中IgM、IgG和NS1Ag的存在情况。采用传统多重逆转录聚合酶链反应（RT-PCR）和多重实时RT-PCR检测法进行登革热病毒的检测和血清分型。
快速卡片检测共有196份样本呈阳性。其中，139份NS1Ag阳性，40份仅IgM阳性，5份仅IgG阳性，12份样本抗原和抗体的不同组合呈阳性。通过PCR在这些样本中检测到所有四种血清型。发现DENV-3是最常见的流行血清型。共发现22例患者感染了不止一种登革热血清型。快速卡片检测仅含抗体而无抗原的样本通过PCR检测病毒也呈阳性。
登革热共同感染的患病率正在上升。此外，对于快速检测未显示NS1Ag但有其中一种或两种抗体的样本，筛查登革热病毒也很重要。发现实时多重RT-PCR在检测共同感染方面比传统多重RT-PCR更敏感。
