2019
DOI: 10.3390/diagnostics10010011
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Flavivirus Cross-Reactivity to Dengue Nonstructural Protein 1 Antigen Detection Assays

Abstract: Dengue virus (DENV) and Zika virus (ZIKV) are flaviviruses of public health relevance. Both viruses circulate in the same endemic settings and acute infections generally manifest similar symptoms. This highlights the importance of accurate diagnosis for clinical management and outbreak control. One of the commonly used acute diagnostic markers for flaviviruses is nonstructural protein 1 (NS1). However, false positives due to antigenic cross-reactivity have been reported between DENV and ZIKV infections when us… Show more

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Cited by 12 publications
(13 citation statements)
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“…However, quoted accuracy of the SD Dengue Duo NS1 antigen and IgG/IgM combo test is high: with the sensitivity and specificity of 92.8 and 98.4, respectively, for the NS1 side; 99.4 and 93.0, respectively, for the IgM/IgG side [42]. Also, previous studies support that commercial kits based on dengue NS1 antigen detection perform well in clinical samples from areas with multiple flaviviruses in circulation [41,43]. Furthermore, in the current study, the RDTs were used for screening, rather than for confirmation of dengue infection.…”
Section: Use Of Dengue Rdt Clinical Diagnosis and Antibioticsmentioning
confidence: 86%
See 1 more Smart Citation
“…However, quoted accuracy of the SD Dengue Duo NS1 antigen and IgG/IgM combo test is high: with the sensitivity and specificity of 92.8 and 98.4, respectively, for the NS1 side; 99.4 and 93.0, respectively, for the IgM/IgG side [42]. Also, previous studies support that commercial kits based on dengue NS1 antigen detection perform well in clinical samples from areas with multiple flaviviruses in circulation [41,43]. Furthermore, in the current study, the RDTs were used for screening, rather than for confirmation of dengue infection.…”
Section: Use Of Dengue Rdt Clinical Diagnosis and Antibioticsmentioning
confidence: 86%
“…In the current study, we referred to only the NS1 results for assessment of the test performance of the dengue RDT. However, to compare with the clinical diagnosis, we referred to positivity either based on IgM and/or NS1 kit of the RDT and there may be concerns of cross-reactivity between flaviviruses reported in antibody assays and tests for dengue NS1 antigen [ 40 , 41 ]. However, quoted accuracy of the SD Dengue Duo NS1 antigen and IgG/IgM combo test is high: with the sensitivity and specificity of 92.8 and 98.4, respectively, for the NS1 side; 99.4 and 93.0, respectively, for the IgM/IgG side [ 42 ].…”
Section: Discussionmentioning
confidence: 99%
“…Furthermore, some commercial dengue antigen diagnostic tests have produced false-positives in detecting the dengue virus NS1 antigen when applied to patients infected with Zika virus (45). Other tests have produced false-positives when applied to the culture supernatant of cells infected with other flaviviruses (46). False positives results can lead to overestimates of the burden associated with dengue (34).…”
Section: Discussionmentioning
confidence: 99%
“…DENV and ZIKV flavivirus showed high structural similarity and cross-reactive immune response, which results in false positives during serological tests, precisely in secondary infections. The present serological test includes NS1 and E proteins as antigenic targets (Tan et al, 2019 ). The precision and accuracy of the test depend on the infection stage.…”
mentioning
confidence: 99%