title: Diagnosis of dengue virus infection by detection of specific immunoglobulin M (IgM) and IgA antibodies in serum and saliva.
abstract: To evaluate alternative approaches to the serological diagnosis of dengue virus (DEN) infection, the detection of DEN-specific immunoglobulin M (IgM) and IgA antibodies in serum and saliva specimens was assessed in 147 patients with symptoms of DEN infection seen at the Ministry of Health in Nicaragua. Seventy-two serum samples were determined to be positive for anti-DEN antibodies by IgM capture enzyme-linked immunosorbent assay, the routine diagnostic procedure. Serum and saliva specimens were obtained from 50 healthy adults as additional controls. IgM was detected in the saliva of 65 of the 72 serum IgM-positive cases, 6 of the 75 serum IgM-negative cases, and none of the control group, resulting in a sensitivity of 90.3% and a specificity of 92.0% and demonstrating that salivary IgM is a useful diagnostic marker for DEN infection. Detection of IgA in serum may be another feasible alternative for the diagnosis of DEN infection, with serum IgA found in 68 (94.4%) of the IgM-positive cases. In contrast, detection of IgA in saliva was not found to be a useful tool for DEN diagnosis in the present study. Further studies of the kinetics of antibody detection in another set of 151 paired acute- and convalescent-phase serum samples showed that DEN-specific IgA antibodies were detected in more acute-phase samples than were IgM antibodies. Thus, we conclude that DEN-specific IgA in serum is a potential diagnostic target. Furthermore, given that saliva is a readily obtainable, noninvasive specimen, detection of DEN-specific salivary IgM should be considered a useful, cheaper diagnostic modality with similar sensitivity and specificity to IgM detection in serum.
authors.affiliation: National Center for Diagnosis and Reference, Ministry of Health, Granada, Nicaragua.
authors.forename: Angel
authors.initials: A
authors.lastname: Balmaseda
authors.forename: María G
authors.initials: MG
authors.lastname: Guzmán
authors.forename: Samantha
authors.initials: S
authors.lastname: Hammond
authors.forename: Guillermo
authors.initials: G
authors.lastname: Robleto
authors.forename: Carolina
authors.initials: C
authors.lastname: Flores
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Téllez
authors.forename: Elsa
authors.initials: E
authors.lastname: Videa
authors.forename: Saira
authors.initials: S
authors.lastname: Saborio
authors.forename: Leonel
authors.initials: L
authors.lastname: Pérez
authors.forename: Erick
authors.initials: E
authors.lastname: Sandoval
authors.forename: Yoryelin
authors.initials: Y
authors.lastname: Rodriguez
authors.forename: Eva
authors.initials: E
authors.lastname: Harris
mesh_terms: D000914:Antibodies, Viral / Q000032:analysis / Q000097:blood*; D000918:Antibody Specificity; D003715:Dengue / Q000175:diagnosis* / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000097:blood; D007075:Immunoglobulin M / Q000032:analysis / Q000097:blood; D007700:Kinetics; D012463:Saliva / Q000276:immunology / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D007070:Immunoglobulin A; D007075:Immunoglobulin M