title: The diagnostic and prognostic value of dengue non-structural 1 antigen detection in a hyper-endemic region in Indonesia.
abstract: As dengue fever is undifferentiated from other febrile illnesses in the tropics and the clinical course is unpredictable, early diagnosis is important. Several commercial assays to detect dengue NS1 antigen have been developed; however, their performances vary and data is lacking from hyper-endemic areas where all four serotypes of dengue are equally represented. To assess the sensitivity of the Bio-Rad platelia Dengue NS1 antigen assay according to virus serotype, immune status, gender, and parameters of severe disease, acute sera from 220 individuals with confirmed dengue and 55 individuals with a non-dengue febrile illness were tested using the Bio-Rad platelia Dengue NS1 antigen assay. The overall sensitivity of the NS1 ELISA was 46.8% and the specificity was 100%. The sensitivity in primary infections was significantly higher than in secondary infections (100% vs. 35.7%). In secondary infections, the sensitivity of NS1 detection was highest in DENV-3 (47.1%), followed by DENV-1 (40.9%), DENV-2 (30%) and DENV-4 (27%) infections. NS1 was less frequently detected in sera with high titers of HI antibodies or in acute samples from patients whose pre-illness sera showed neutralizing antibodies to more than one serotype. The detection of NS1 was higher in females, severe cases, and individuals with lower platelet counts (<100,000/mm(3)). While the overall sensitivity of this NS1 ELISA is poor, our data suggest that in secondary infections, detection may be predictive of a more severe illness.
authors.affiliation: Health Research Unit, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia ; Viral Diseases Program, U.S. Naval Medical Research Unit 2, Jakarta, Indonesia.
authors.forename: Herman
authors.initials: H
authors.lastname: Kosasih
authors.forename: Bachti
authors.initials: B
authors.lastname: Alisjahbana
authors.forename: Susana
authors.initials: S
authors.lastname: Widjaja
authors.lastname: Nurhayati
authors.forename: Quirijn
authors.initials: Q
authors.lastname: de Mast
authors.forename: Ida
authors.initials: I
authors.lastname: Parwati
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Blair
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Burgess
authors.forename: Andre
authors.initials: A
authors.lastname: van der Ven
authors.forename: Maya
authors.initials: M
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D003716:Dengue Virus / Q000737:chemistry / Q000276:immunology / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000175:diagnosis; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007214:Indonesia; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D017361:Viral Nonstructural Proteins / Q000097:blood*
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D000956:Antigens, Viral; D007075:Immunoglobulin M; C079340:NS1 protein, Dengue virus type 2; C546113:NS1 protein, Dengue virus type 3; C082515:NS1 protein, dengue-1 virus; D011933:Reagent Kits, Diagnostic; D017361:Viral Nonstructural Proteins