title: B-cell antigen D8/17 is a marker of rheumatic fever susceptibility in Aboriginal Australians and can be tested in remote settings.
abstract: OBJECTIVE
  To test the B-cell antigen D8/17 as a marker of past rheumatic fever (RF) in a predominantly Aboriginal Australian population, and to evaluate technical modifications to allow its use in remote settings.
  
  
  METHODS
  Cross-sectional survey in a remote Aboriginal community, a regional tertiary referral hospital and a tertiary paediatric centre in Melbourne.
  
  
  METHODS
  106 people, including three with acute RF, 38 with a history of past RF, 20 relatives of these people, and 45 healthy controls.
  
  
  METHODS
  D8/17 expression in B cells.
  
  
  RESULTS
  Blood was collected from each participant and the expression of D8/17 and CD19 in each sample was analysed by flow cytometry. The mean proportion of D8/17-positive B cells was 39.3% (SD, 11.8) in patients with previous RF, 22.5% (SD, 5.2) in first-degree relatives, 11.6% (SD, 7.2) in controls, and 83.7% (SD, 10.1) in patients with acute RF (analysis of variance test between means, P = 0.001). A cut-off of 22.1% of D8/17-positive B cells to indicate past RF yielded the highest percentage of correct results (95.4%). Delayed staining of whole blood (mean, 0.55 days; SD, 0.2) gave equivalent results to immediate staining, but the D8/17 assay on peripheral blood mononuclear cells was unreliable.
  
  
  CONCLUSIONS
  The B-cell antigen D8/17 accurately identifies Australians with a past history of RF, and the assay is feasible in remote settings with access to facilities capable of performing D8/17 staining within half a day of sample collection.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia. zintah@bigpond.com
authors.forename: Zinta
authors.initials: Z
authors.lastname: Harrington
authors.forename: Kumar
authors.initials: K
authors.lastname: Visvanathan
authors.forename: Narelle A
authors.initials: NA
authors.lastname: Skinner
authors.forename: Nigel
authors.initials: N
authors.lastname: Curtis
authors.forename: Bart J
authors.initials: BJ
authors.lastname: Currie
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Carapetis
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D005260:Female; D005434:Flow Cytometry; D020022:Genetic Predisposition to Disease; D006297:Health Services Accessibility; D006801:Humans; D007519:Isoantigens / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015876:Northern Territory / Q000453:epidemiology; D012372:ROC Curve; D015203:Reproducibility of Results; D012213:Rheumatic Fever / Q000208:ethnology* / Q000235:genetics*; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: C082034:B-cell alloantigen D8-17; D015415:Biomarkers; D004396:Coloring Agents; D007519:Isoantigens