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Clinical and Vaccine Immunology, October 2008, p. 1513-1518, Vol. 15, No. 10
1071-412X/08/$08.00+0     doi:10.1128/CVI.00140-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Comparison of Two Commercially Available Dengue Virus (DENV) NS1 Capture Enzyme-Linked Immunosorbent Assays Using a Single Clinical Sample for Diagnosis of Acute DENV Infection

Kovi Bessoff,¹ Mark Delorey,² Wellington Sun,¹ and Elizabeth Hunsperger^1*

Centers for Disease Control and Prevention (CDC), Division of Vector-Borne Infectious Diseases (DVBID), Dengue Branch, San Juan, Puerto Rico,¹ Centers for Disease Control and Prevention (CDC), Division of Vector-Borne Infectious Diseases (DVBID), Fort Collins, Colorado²

Received 16 April 2008/ Returned for modification 3 July 2008/ Accepted 28 July 2008

Dengue virus (DENV) nonstructural protein 1 (NS1) has shown promise as a novel diagnostic marker of acute DENV infection. Current techniques used to diagnose acute DENV infection, including virus isolation and reverse transcription-PCR (RT-PCR), are costly and difficult to perform, while traditional serological assays have low sensitivities during the acute stage of infection. Two commercially available NS1 antigen capture enzyme-linked immunosorbent assays (ELISAs), the Platelia dengue NS1Ag test (Bio-Rad Laboratories, Marnes La Coquette, France) and the Pan-E dengue early ELISA test (Panbio Diagnostics, Brisbane, Australia), were evaluated against a well-characterized panel of 208 real-time RT-PCR- and virus isolation-positive sera, as well as 45 real-time RT-PCR- and serologically negative sera from patients with other acute febrile illnesses. The overall sensitivities were 64.9% (95% confidence interval [CI₉₅], 58.2 to 71.1%) for the Panbio test and 83.2% (CI₉₅, 77.5 to 87.7%) for the Bio-Rad test, with interserotype variation, especially for DENV serotype 4. Predictive models were constructed to identify factors that had a significant influence on a test's outcome with respect to this panel of samples in order to identify the conditions in which the test will be most effective as a diagnostic tool. The immunoglobulin G titer was found to be the only covariate that significantly influenced results in the Bio-Rad test, while serotype and the day postonset were found to significantly influence results in the Panbio test. We concluded that the NS1 capture ELISA is a useful tool that can improve testing algorithms to diagnose DENV infection in single samples from acute and early convalescent cases.

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* Corresponding author. Mailing address: United States Public Health Service, CDC-Dengue Branco, 1324 Calle Cañada, San Juan, PR 00920. Phone: (787) 706-2474. Fax: (787) 706-2496. E-mail: enh4{at}cdc.gov

Published ahead of print on 6 August 2008.

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Clinical and Vaccine Immunology, October 2008, p. 1513-1518, Vol. 15, No. 10
1071-412X/08/$08.00+0     doi:10.1128/CVI.00140-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

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