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Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 18 / No. 2 / Published : 2012-01

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Original Article :

Ns1 antigen dengue virus infection associated with serotypes of dengue virus

Author :

  1. Roudhotul Ismaillya Noor*1
  2. Aryati*2
  3. Puspa Wardhani*3
  1. Bag PK FK-UNAIR/RSU Dr. Soetomo Surabaya
  2. Departemen Patologi Klinik FK. UNAIR-RSUD Dr. Soetomo Surabaya/Lembaga Penyakit Tropis Universitas Airlangga
  3. Departemen Patologi Klinik FK. UNAIR-RSUD Dr. Soetomo Surabaya/Lembaga Penyakit Tropis Universitas Airlangga

Abstract :

Dengue virus infection (DVI) currently is detected by using dengue virus NS1 antigen (NS1 Ag). The sensitivity of NS1 Ag is 27.8% - 93.4%, but recent study of Kumarasamy the sensitivity of NS1 Ag is better than the virus isolation and polymerase chain reaction (PCR). This study is focussed on the evaluation of the validity of Panbio Dengue Early Rapid for the diagnosis of  DVI and the NS1 Ag sensitivity associated with dengue virus serotypes. The sera was obtained from 65 DVI patients which diagnosed by the clinicians. The resulted diagnosis was found by serology tests (positive IgM/IgG antidengue/NS1 Ag ELISA) and 1997 WHO criteria as the  gold standard, and which also found 35 non DVI patients (typhoid fever, HAV, malaria, UTI, tuberculosis and bronchopneumonia). The samples were examined by Panbio Dengue Early Rapid. PCR was performed on each positive serological test result to determine the dengue virus serotypes. The sensitivity  and specificity of  Panbio Dengue Early Rapid was 49.2% and 100%. The PCR results of 65 sera showed positive PCR in 49.2% (positive NS1 Ag was 62.5%). Meanwhile, and negative PCR in 50.8% (positive NS1 Ag was 36.4%). The predominance of serotypes (positive NS1 Ag) were DEN-3 (37.5%), DEN-4 (28.1%),  DEN-1 (21.9%) and DEN-2 (12.5%). The Panbio Dengue Early Rapid can be used as early detection of DVI, although it should be used in conjunction with other dengue serological tests as well. Unfortunately there is still not enough evidence about the NS1 Ag sensitivity associated with the dengue virus serotypes.     Diagnosis infeksi virus dengue (IVD) dapat ditetapkan dengan pemeriksaan antigen virus dengue (Ag NS1). Pemeriksaan antigen NS1 memiliki kepekaan 27,8% ― 93,4%, tetapi berdasarkan penelitian terbaru Kumarasamy bahwa kepekaan Ag NS1 lebih unggul dibandingkan dengan biakan virus dan polymerase chain reaction (PCR). Penelitian ini bertujuan menilai kesahihan uji Panbio Dengue Early Rapid  (Ag NS1) sebagai penunjang diagnosis IVD terkait serotipe virus dengue terhadap kepekaan diagnostik. Serum 65 penderita terdiagnosis IVD oleh peklinik (patokan WHO 1997), sebagai baku emas digunakan patokan WHO 1997 dan pemeriksaan serologik IgM/IgG antidengue/Ag NS1 ELISA yang positif, dan kelompok nondengue yaitu 35 penderita yang terbukti demam penyakit lain (demam tifoid, hepatitis A, malaria, ISK, tuberkulosis dan bronchopneumonia). Semua sampel diperiksa dengan Panbio Dengue Early Rapid. PCR dilakukan untuk mengetahui serotipe virus dengue apabila salah satu pemeriksaan serologisnya positif. Kepekaan dan kekhasan Panbio Dengue Early Rapid adalah 49,2% dan 100%. Hasil PCR 65 sampel didapatkan PCR positif 49,2% (Ag NS1 positif 62,5%). Hal yang menarik, dari PCR negatif 50,8% dijumpai 36,4% Ag NS1 positif. Dominasi serotipe dengan Ag NS1 positif adalah DEN-3 (37,5%), DEN-4 (28,1%), DEN-1 (21,9%) dan DEN-2 (12,5%). Pemeriksaan Panbio Dengue Early Rapid dapat digunakan sebagai temuan dini pemeriksaan IVD, namun karena kepekaan rendah maka sebaiknya digabungkan dengan uji serologik lain. Penelitian ini menunjukkan bahwa belum cukup terbukti keterkaitan pengaruh serotipe virus dengue terhadap kepekaan diagnostiknya.

Keyword :

Dengue virus infection, NS1 antigen, dengue virus serotypes,

References :

  1. World Health Organization, (2009). Dengue Guidelines for diagnosis, treatment, prevention and control. Geneva : New edition WHO and TDR
  2. 2. De Rivera IL, Parham L, Murillo W, Moncada W, Vazquez S, (2008). Humoral Immune Response of Dengue Hemorrhagic Fever Cases in Children from Tegucigalpa, Honduras. Honduras : The American Society of Tropical Medicine and Hygiene
  3. 3. Libraty DH, Young PR, Pickering D, Endy TP, Kalayanarooj S, Green S, (2002). High circulating levels of the dengue virus nonstructural protein NS1 early in dengue illness correlate with development of dengue hemorrhagic fever. USA : J Infect Dis
  4. 4. Dussart P, Labeau B, Lagathu GI, Louis P, Nunes MRT, Rodrigues SG, (2006). Evaluation of an enzyme immunoassay for detection of dengue virus NS1 antigen in human serum. USA : Clin Vac Immunol
  5. 5. Kumarasamy V, Chua SK, Hasan Z, Wahab AHA, Chem YK, Mohamad M, (2007). Evaluating the sensitivity of a commercial dengue NS1 antigen-captured ELISA for early diagnosis of acute dengue virus infection. Singapore : Singapore Med J


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