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Clinical and Vaccine Immunology, September 2006, p. 1044-1051, Vol. 13, No. 9
1071-412X/06/$08.00+0     doi:10.1128/CVI.00105-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Altered Enzyme-Linked Immunosorbent Assay Immunoglobulin M (IgM)/IgG Optical Density Ratios Can Correctly Classify All Primary or Secondary Dengue Virus Infections 1 Day after the Onset of Symptoms, when All of the Viruses Can Be Isolated

Andrew K. I. Falconar,1* Elsa de Plata,2 and Claudia M. E. Romero-Vivas1

Grupo de Investigaciones en Enfermedades Tropicales, Departamento de Ciéncias Básicas Medicas, Universidad del Norte, Barranquilla, Colombia,1 Oficina Distrital de Salud Publica de Barranquilla, Barranquilla, Colombia2

Received 6 March 2006/ Returned for modification 28 April 2006/ Accepted 7 July 2006

We compared dengue virus (DV) isolation rates and tested whether acute primary (P) and acute/probable acute secondary (S/PS) DV infections could be correctly classified serologically when the patients' first serum (S1) samples were obtained 1 to 3 days after the onset of symptoms (AOS). DV envelope/membrane protein-specific immunoglobulin M (IgM) capture and IgG capture enzyme-linked immunosorbent assay (ELISA) titrations (1/log10 1.7 to 1 log10 6.6 dilutions) were performed on 100 paired S1 and S2 samples from suspected DV infections. The serologically confirmed S/PS infections were divided into six subgroups based on their different IgM and IgG responses. Because of their much greater dynamic ranges, IgG/IgM ELISA titer ratios were more accurate and reliable than IgM/IgG optical density (OD) ratios recorded at a single cutoff dilution for discriminating between P and S/PS infections. However, 62% of these patients' S1 samples were DV IgM and IgG titer negative (<ODmax/2 titer threshold), and in 35% of the S/PS infections, the patients' S1 and S2 samples were IgM titer negative. The IgM OD values were, however, much higher than those of IgG in the S1 samples of many of these, and the other, S/PS infections. This necessitated using higher (≥2.60 and <2.60) discriminatory IgM/IgG OD (DOD) ratios on these S1 samples than those published previously to correctly classify the highest percentage of these P and S/PS infections. The DV isolation rate was highest (12/12; 100%) using IgG and IgM titer-negative S1 samples collected 1 day AOS, when 100% of them were correctly classified as P or S/PS infections using these higher DOD ratios.

* Corresponding author. Mailing address: Grupo de Investigaciones en Enfermedades Tropicales, Departmento de Ciéncias Básicas Medicas, Universidad del Norte, Km5 via Puerto Colombia, Barranquilla, Colombia. Phone: (57) 5 3509478. Fax: (57) 5 3509233. E-mail: afalconar{at}uninorte.edu.co.

Clinical and Vaccine Immunology, September 2006, p. 1044-1051, Vol. 13, No. 9
1071-412X/06/$08.00+0     doi:10.1128/CVI.00105-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Prince, H. E., Yeh, C., Lape-Nixon, M. (2008). Development of a More Efficient Algorithm for Identifying False-Positive Reactivity Results in a Dengue Virus Immunoglobulin M Screening Assay. CVI 15: 1304-1306 [Abstract] [Full Text]  
  • Falconar, A. K. I. (2007). Antibody Responses Are Generated to Immunodominant ELK/KLE-Type Motifs on the Nonstructural-1 Glycoprotein during Live Dengue Virus Infections in Mice and Humans: Implications for Diagnosis, Pathogenesis, and Vaccine Design. CVI 14: 493-504 [Abstract] [Full Text]  


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