Details

Autor(en) / Beteiligte

• Gouel-Cheron, Aurelie
• Lumbard, Keith
• Hunsberger, Sally
• Arteaga-Cabello, Fernando J.
• Beigel, John
• Belaunzarán-Zamudio, Pablo F.
• Caballero-Sosa, Sandra
• Escobedo-López, Kenia
• Ibarra-González, Violeta
• Nájera-Cancino, José Gabriel
• Rincón-León, Héctor Armando
• Ruiz-Hernández, Emilia
• Sepúlveda-Delgado, Jesús
• Trujillo-Murillo, Karina
• Ruiz-Palacios, Guillermo

Titel

Serial real-time RT-PCR and serology measurements substantially improve Zika and Dengue virus infection classification in a co-circulation area

Ist Teil von

• Antiviral research, 2019-12, Vol.172, p.104638-104638, Article 104638

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Real-time RT-PCR (Reverse Transcriptase Polymerase Chain Reaction) is considered the gold standard for Zika virus (ZIKV) infection diagnosis, despite its low sensitivity. Diagnosis using recommended serologic cutoffs in co-circulating Flaviviruses areas maybe inadequate due to in-vitro cross-reactivities of Flaviviruses-specific antibodies. We evaluated Zika diagnosis in symptomatic patients using serial RT-PCR and develop a classification model using serial Dengue virus (DENV) and ZIKV serologies. A prospective longitudinal multicentric study in Southern Mexico (NCT02831699) enrolled symptomatic and non-symptomatic participants. In the classification model, true positives were symptomatic (using a modified World Health Organization/Pan American Health Organization definition) with RT-PCR positive for ZIKV or DENV. True negatives were non-symptomatic with negative RT-PCR. Serial serology measurements were used to predict disease status. Analyzing ZIKV and DENV RT-PCR at 3 timepoints between days 3 and 13 of symptom onset detected 25% more cases than a single RT-PCR analysis between day 0 and 6. When considering sensitivity and specificity together, the serial serology model predicted all categories of disease and negatives better than manufactures cutoffs. Their cutoffs optimized sensitivity or specificity but not both. We demonstrated the importance of serial RT-PCR and antibody measurements to diagnose arbovirus infection in symptomatic patients living in regions with co-circulating flaviviruses. •Serial RT-PCR evaluation until day 13 increases by 25% the identification of patients infected by Zika Virus.•Cutoffs for Zika and Dengue virus serologic tests validated in traveler cohorts do not apply on endemic population.•Zika virus serologic kinetics could help to target population that should benefit from a closer monitoring.