Use of the immunoglobulin G avidity assay to differentiate between recent Zika and past dengue virus infections

Andrea K.M. Furuya, Danielle Hunt, Kirsten St. George, Alan P. Dupuis, Laura D. Kramer, Pei-Yong Shi, Susan Wong

Research output: Contribution to journalArticle

Abstract

Zika (ZIKV) and dengue (DENV) virus infections elicit a robust but cross-reactive antibody response against the viral envelope protein, while antibody responses against non-structural proteins (NS) are more virus specific. Building on this premise, we have previously developed a flavivirus multiplex microsphere immunoassay (MIA) for the serologic diagnosis of ZIKV and DENV infections. This assay significantly improved diagnostic accuracy; however, MIA could not differentiate more recent from past infections, which still represents a major diagnostic challenge. Therefore, an immunoglobulin G (IgG) based avidity assay was developed and its diagnostic performance evaluated. Specimens from New York State residents were submitted to the Wadsworth Center New York State Department of Health (NYSDOH) for routine clinical testing by Zika IgM ELISA and plaque reduction neutralization test (PRNT). Using our previously developed flavivirus MIA as a platform, we developed an IgG avidity assay to discriminate recent ZIKV from past DENV infections. Zika IgM positive specimens had an average Zika IgG avidity index of 14.8% (95% CI: 11.0–18.4%), while Zika IgM negative but flavivirus MIA and PRNT positive samples had an average Zika IgG avidity index of 34.9% (95% CI: 31.1–38.7%). Specimens positive for dengue antibodies by flavivirus MIA and PRNT had an average dengue IgG avidity index of 68.7% (95% CI: 62.7–75.0%). The IgG avidity assay accurately distinguished recent ZIKV from past DENV infections in patients who traveled to dengue endemic regions. This assay could be very useful in patients with high risk of Zika complications such as pregnant women and monitoring immune responses in vaccine trials.

Original languageEnglish (US)
Pages (from-to)859-867
Number of pages9
JournalClinical Science
Volume133
Issue number7
DOIs
StatePublished - Apr 15 2019

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Dengue Virus
Virus Diseases
Flavivirus
Microspheres
Immunoassay
Immunoglobulin G
Neutralization Tests
Dengue
Immunoglobulin M
Infection
Antibody Formation
Viral Envelope Proteins
Immunologic Monitoring
Pregnant Women
Vaccines
Enzyme-Linked Immunosorbent Assay
Viruses
Antibodies
Health
Proteins

ASJC Scopus subject areas

  • Medicine(all)

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Use of the immunoglobulin G avidity assay to differentiate between recent Zika and past dengue virus infections. / Furuya, Andrea K.M.; Hunt, Danielle; St. George, Kirsten; Dupuis, Alan P.; Kramer, Laura D.; Shi, Pei-Yong; Wong, Susan.

In: Clinical Science, Vol. 133, No. 7, 15.04.2019, p. 859-867.

Research output: Contribution to journalArticle

Furuya, Andrea K.M. ; Hunt, Danielle ; St. George, Kirsten ; Dupuis, Alan P. ; Kramer, Laura D. ; Shi, Pei-Yong ; Wong, Susan. / Use of the immunoglobulin G avidity assay to differentiate between recent Zika and past dengue virus infections. In: Clinical Science. 2019 ; Vol. 133, No. 7. pp. 859-867.
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