title: Inferring the serotype associated with dengue virus infections on the basis of pre- and postinfection neutralizing antibody titers.
abstract: BACKGROUND
  Currently, the only tests capable of determining the serotype associated with dengue virus (DENV) infection require sampling during the period of acute viremia. No test can accurately detect the serotype associated with past DENV infections. The standard assay for determination of serotype-specific antibody against DENV is the plaque reduction neutralization test (PRNT), although performance of this test continues to be evaluated.
  
  
  METHODS
  From a cohort study among schoolchildren in Thailand, PRNT values were determined in serum samples collected before and after infection. A multinomial logistic regression model was used to infer the serotype associated with intercurrent DENV infections. Models were validated based on polymerase chain reaction identification of DENV serotypes.
  
  
  RESULTS
  The serotype associated with DENV infection inferred by the model corresponded with polymerase chain reaction in 67.6% of cases, and the kappa statistic was 0.479. A model for 35 cases with primary seroconversion correctly identified the DENV serotypes causing infection in 77.1% of cases, compared with 66.9%, using a model for 169 cases with secondary seroconversion. The best model using only postinfection PRNT values correctly inferred the DENV serotype causing infection in 60.3% of cases.
  
  
  CONCLUSIONS
  A statistical model based on both pre- and postinfection PRNT values can be used to infer the serotype associated with DENV infections in prospective studies and vaccine trials.
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA. wav10@pitt.edu
authors.forename: Willem G
authors.initials: WG
authors.lastname: van Panhuis
authors.forename: Robert V
authors.initials: RV
authors.lastname: Gibbons
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Endy
authors.forename: Alan L
authors.initials: AL
authors.lastname: Rothman
authors.forename: Anon
authors.initials: A
authors.lastname: Srikiatkhachorn
authors.forename: Ananda
authors.initials: A
authors.lastname: Nisalak
authors.forename: Donald S
authors.initials: DS
authors.lastname: Burke
authors.forename: Derek A T
authors.initials: DA
authors.lastname: Cummings
mesh_terms: D000293:Adolescent; D057134:Antibodies, Neutralizing / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D002648:Child; D003715:Dengue / Q000821:virology*; D003716:Dengue Virus / Q000145:classification* / Q000276:immunology*; D006801:Humans; D009500:Neutralization Tests; D012703:Serotyping / Q000379:methods; D013785:Thailand; D010948:Viral Plaque Assay
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral