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J Clin Virol. 2014 Nov;61(3):353-8. doi: 10.1016/j.jcv.2014.08.021. Epub 2014 Sep 1.

Approach to non-invasive sampling in dengue diagnostics: exploring virus and NS1 antigen detection in saliva and urine of travelers with dengue.

Author information

1
Department of Virology, Haartman Institute, Faculty of Medicine, P.O. Box 21 (Haartmaninkatu 3), FIN-00014 University of Helsinki, Helsinki, Finland. Electronic address: essi.m.korhonen@helsinki.fi.
2
Department of Virology, Haartman Institute, Faculty of Medicine, P.O. Box 21 (Haartmaninkatu 3), FIN-00014 University of Helsinki, Helsinki, Finland.
3
Division of Microbiology and Epidemiology, Department of Basic Veterinary Sciences, P.O. Box 66 (Agnes Sjöbergin katu 2), FIN-00014 University of Helsinki, Helsinki, Finland.
4
Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland; Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
5
Department of Virology, Haartman Institute, Faculty of Medicine, P.O. Box 21 (Haartmaninkatu 3), FIN-00014 University of Helsinki, Helsinki, Finland; Division of Microbiology and Epidemiology, Department of Basic Veterinary Sciences, P.O. Box 66 (Agnes Sjöbergin katu 2), FIN-00014 University of Helsinki, Helsinki, Finland; Department of Virology and Immunology, Helsinki University Central Hospital Laboratory (HUSLAB), P.O. Box 400 (Haartmaninkatu 3), 00029 HUS, Finland.

Abstract

BACKGROUND:

Dengue diagnostics currently relies on serum and plasma tests. Although the proof of concept for detecting dengue virus (DENV) RNA and nonstructural protein 1 (NS1) antigen from urine and saliva has been demonstrated, few studies have explored their use in diagnostics.

OBJECTIVES:

To investigate the occurrence, excretion kinetics, and diagnostic potential of DENV-RNA and NS1 antigen in the urine and saliva of dengue patients.

STUDY DESIGN:

We examined serial serum, urine (n=50) and saliva (n=48) samples of 14 Finnish travelers with dengue. All samples were analyzed by NS1 ELISA and DENV RT-PCR, and the first and last serum specimens were tested for DENV IgG and IgM. In addition, biochemical parameters were studied from the urine and clinical and laboratory data of the patients were collected.

RESULTS:

DENV-NS1 protein and RNA proved detectable from saliva and urine using tests developed for serum samples. RNA/NS1 detection showed a diagnostic sensitivity of 64%/54% and 60%/56% for urine and saliva, respectively. RNA analyses performed on days 7-13 after onset of symptoms revealed the sensitivity for urine (72%) to be greater than for serum (31%) or saliva (50%). The concentration of urine samples had no impact on RNA detection.

CONCLUSIONS:

Noninvasive sampling enables an alternative approach to dengue diagnostics. The performance of the NS1 antigen assay may be improved by optimizing it for urine and saliva samples. The prolonged excretion of DENV-RNA in urine extends the sampling time window for molecular diagnostics and surveillance.

KEYWORDS:

Dengue diagnostics; NS1; Non-invasive; RNA; Real-time RT-PCR; Saliva; Urine

PMID:
25242312
DOI:
10.1016/j.jcv.2014.08.021
[Indexed for MEDLINE]

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