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Clinical and Vaccine Immunology, November 2007, p. 1433-1436, Vol. 14, No. 11
1071-412X/07/$08.00+0     doi:10.1128/CVI.00056-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Use of Antibody Avidity Assays for Diagnosis of Severe Acute Respiratory Syndrome Coronavirus Infection{triangledown}

K. H. Chan,1 K. Sonnenberg,2 M. Niedrig,3 S. Y. Lam,1 C. M. Pang,1 K. M. Chan,1 S. K. Ma,1 W. H. Seto,1 and J. S. M. Peiris1,4*

Department of Microbiology, The University of Hong Kong and Queen Mary Hospital, Hong Kong, SAR, People's Republic of China,1 Euroimmun AG, Luebeck, Germany,2 Robert Koch Institute, Berlin, Germany,3 HKU-Pasteur Research Centre, Hong Kong, SAR, People's Republic of China4

Received 24 January 2007/ Returned for modification 14 May 2007/ Accepted 8 September 2007

An indirect immunofluorescent assay (Euroimmun AG, Luebeck, Germany) was used to investigate the avidity of immunoglobulin G (IgG), IgM, IgA, and total Ig (IgGAM) antibody responses to severe acute respiratory syndrome coronavirus (SARS CoV) infections. Serial serum samples from eight patients collected during the first, third, and ninth months after the onset of infection were evaluated. It was found that low-avidity IgG antibodies were detected in 15/15 (100%), 1/5 (20%), and 0/8 (0%) serum samples collected during the first, third, and ninth months after the onset of symptoms, respectively. Low-avidity antibodies of IgA and IgM subclasses were detected in 14/14 (100%) and 3/14 (21%) serum samples, respectively, collected in the first month after the onset of infection. However, IgA antibodies remained low in avidity in a proportion of patients even during late convalescence. As a consequence, IgG antibody avidity assays gave better discrimination between acute-phase and late-convalescent-phase serum samples than IgM, IgA, or IgGAM assays. In two of these patients, sequential serum samples were also tested for IgG avidity against human CoV strains OC43 and 229E in parallel. While SARS CoV infections induced an anamnestic IgG antibody response to the 229E and OC43 viruses, these cross-reactive antibodies remained of high avidity from early (the first month) postinfection. The results showed that assays to detect low-avidity antibody may be useful for discriminating early from late antibody responses and also for distinguishing anamnestic cross-reactive antibody responses from primary specific responses. This may be useful in some clinical situations.

* Corresponding author. Mailing address: Department of Microbiology, University Pathology Building, Queen Mary Hospital Compound, Pokfulam, Hong Kong, SAR, People's Republic of China. Phone: 852-2855-4888. Fax: 852-2855-1241. E-mail: malik{at}hkucc.hku.hk

{triangledown} Published ahead of print on 19 September 2007.

Clinical and Vaccine Immunology, November 2007, p. 1433-1436, Vol. 14, No. 11
1071-412X/07/$08.00+0     doi:10.1128/CVI.00056-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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