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Low Sensitivity of NS1 Protein Tests Evidenced during a Dengue Type 2 Virus Outbreak in Santos, Brazil, in 2010

2012; American Society for Microbiology; Volume: 19; Issue: 12 Linguagem: Inglês

10.1128/cvi.00535-12

1556-6811

Alvina Clara Félix, Camila Malta Romano, Cristiane de Campos Centrone, Celia L. de Lima Rodrigues, Lucy Santos Villas-Boas, Evaldo Stanislau Affonso de Araújo, Andréia Manso de Matos, Karina I. Carvalho, Celina Maria Turchi Martelli, Esper G. Kallás, Cláudio Mendes Pannuti, José Eduardo Levi,

Malaria Research and Control

ABSTRACT In 2010, a large outbreak of dengue occurred in Santos, Brazil. The detection of the NS1 antigen was used for diagnosis in addition to the detection of IgG, IgM, and RNA. A large number of NS1 false-negative results were obtained. A total of 379 RNA-positive samples were selected for thorough evaluation. NS1 was reactive in 37.7% of cases. Most of the cases were characterized as a secondary infection by dengue 2 virus. Sequencing of NS1 positive and negative isolates did not reveal any mutation that could justify the diagnostic failure. Use of existing NS1 tests in the Brazilian population may present a low negative predictive value, and they should be used with caution, preferentially after performing a validation with samples freshly obtained during the ongoing epidemic.