Salivary Detection of H1N1 Virus: A Clinical Feasibility Investigation

Bilder, Leon; Machtei, Eli E.; Shenhar, Yotam; Kra-Oz, Zipi; Basis, Fuad

doi:10.1177/0022034511413283

Cited by 26 publications

(25 citation statements)

References 23 publications

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“…Previously, PCR has been used in the detection of several different virus genomes in saliva; including HIV, dengue, CMV, influenza H1N1, and HHV-7; and in some cases PCR from saliva can be used as an early diagnostic test of infection (Balamane et al, 2010; Bilder et al, 2011; Boppana et al, 2011; Magalhaes Ide et al, 2011; Poloni et al, 2010). Therefore, we compared the time of detectable vDNA in blood with that of oropharyngeal secretions.…”

Section: 0 Resultsmentioning

confidence: 99%

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox – An animal model of smallpox

et al. 2012

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The human population is currently faced with the potential use of natural or recombinant variola and monkeypox viruses as biological weapons. Furthermore, the emergence of human monkeypox in Africa and its expanding environs poses a significant natural threat. Such occurrences would require therapeutic and prophylactic intervention with antivirals to minimize morbidity and mortality of exposed populations. Two orally-bioavailable antivirals are currently in clinical trials; namely CMX001, an ether-lipid analogue of cidofovir with activity at the DNA replication stage and ST-246, a novel viral egress inhibitor. Both of these drugs have previously been evaluated in the ectromelia/mousepox system; however, the trigger for intervention was not linked to a disease biomarker or a specific marker of virus replication. In this study we used lethal, intranasal, ectromelia virus infections of C57BL/6 and hairless SKH1 mice to model human disease and evaluate exanthematous rash (rash) as an indicator to initiate antiviral treatment. We show that significant protection can be provided to C57BL/6 mice by CMX001 or ST-246 when therapy is initiated on day 6 post infection or earlier. We also show that significant protection can be provided to SKH1 mice treated with CMX001 at day 3 post infection or earlier, but this is 4 or more days before detection of rash (ST-246 not tested). Although in this model rash could not be used as a treatment trigger, viral DNA was detected in blood by day 4 post infection and in the oropharyngeal secretions (saliva) by day 2-3 post infection – thus providing robust and specific markers of virus replication for therapy initiation. These findings are discussed in the context of current respiratory challenge animal models in use for the evaluation of poxvirus antivirals.

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Section: 0 Resultsmentioning

confidence: 99%

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox – An animal model of smallpox

et al. 2012

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“…Detection rates could not be directly compared between sampling methods because NPA-negative but saliva-positive cases could not be counted. In another study, all patients diagnosed as H1N1 positive by RT-PCR using NPS specimens were also positive for H1N1 using their saliva specimens (14).…”

Section: Discussionmentioning

confidence: 96%

Comparison between Saliva and Nasopharyngeal Swab Specimens for Detection of Respiratory Viruses by Multiplex Reverse Transcription-PCR

et al. 2017

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Nasopharyngeal swabs (NPSs) are being widely used as specimens for multiplex real-time reverse transcription (RT)-PCR for respiratory virus detection. However, it remains unclear whether NPS specimens are optimal for all viruses targeted by multiplex RT-PCR. In addition, the procedure to obtain NPS specimens causes coughing in most patients, which possibly increases the risk of nosocomial spread of viruses. In this study, paired NPS and saliva specimens were collected from 236 adult male patients with suspected acute respiratory illnesses. Specimens were tested for 16 respiratory viruses by multiplex real-time RT-PCR. Among the specimens collected from the 236 patients, at least 1 respiratory virus was detected in 183 NPS specimens (77.5%) and 180 saliva specimens (76.3%). The rates of detection of respiratory viruses were comparable for NPS and saliva specimens (P ϭ 0.766). Nine virus species and 349 viruses were isolated, 256 from NPS specimens and 273 from saliva specimens (P ϭ 0.1574). Adenovirus was detected more frequently in saliva samples (P Ͻ 0.0001), whereas influenza virus type A and human rhinovirus were detected more frequently in NPS specimens (P ϭ 0.0001 and P ϭ 0.0289, respectively). The possibility of false-positive adenovirus detection from saliva samples was excluded by direct sequencing. In conclusion, neither of the sampling methods was consistently more sensitive than the other. We suggest that these cost-effective methods for detecting respiratory viruses in mixed NPS-saliva specimens might be valuable for future studies. KEYWORDS saliva, respiratory virus, RT-PCR, nasopharyngeal swab Detection of viral pathogens in respiratory illnesses can provide valuable information to direct the proper management of patients and to prevent nosocomial transmission. Although various traditional diagnostic methods, such as direct antigen assays and viral cultures, are used for respiratory virus (RV) detection, nucleic acid amplification tests (NAATs) are thought to be superior in many respects, including sensitivity, specificity, time to virus identification, and range of pathogens detected (1-3).It is generally thought that nasopharyngeal specimens are optimal for detecting RVs, particularly when conventional methods are used (4). Currently, for adult patients, multiplex real-time reverse transcription (RT)-PCR assays using nasopharyngeal swabs (NPSs) are widely applied. However, acquiring NPSs is not as easy as obtaining other types of specimens, such as saliva specimens; this may result in suboptimal specimens, particularly if specimens are obtained by inexperienced personnel. Moreover, the

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“…Recently, there has been renewed interest in using saliva for the detection of respiratory viruses with molecular assays. 18,[26][27][28][29] Some of these studies showed that the detection rate of respiratory viruses was actually higher for saliva than for nasopharyngeal specimens. 18 However, these studies were conducted either in children 28 or among adult patients with mild symptoms who did not require hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“…18,27 Some studies only evaluated the detection of influenza virus. 26,29 Furthermore, many of these studies used special collection devices that are not usually available in most hospitals. The utility of saliva for the detection of respiratory viruses among hospitalized adult patients has not been comprehensively studied.…”

Section: Introductionmentioning

confidence: 99%

Additional molecular testing of saliva specimens improves the detection of respiratory viruses

Yip

et al. 2017

Emerging Microbes & Infections

127

140

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Emerging infectious diseases in humans are often caused by respiratory viruses such as pandemic or avian influenza viruses and novel coronaviruses. Microbiological testing for respiratory viruses is important for patient management, infection control and epidemiological studies. Nasopharyngeal specimens are frequently tested, but their sensitivity is suboptimal. This study evaluated the incremental benefit of testing respiratory viruses in expectorated saliva using molecular assays. A total of 258 hospitalized adult patients with suspected respiratory infections were included. Their expectorated saliva was collected without the use of any special devices. In the first cohort of 159 patients whose nasopharyngeal aspirates (NPAs) tested positive for respiratory viruses during routine testing, the viral load was measured using quantitative reverse transcription PCR. Seventeen percent of the patients (27/159) had higher viral loads in the saliva than in the NPA. The second cohort consisted of 99 patients whose NPAs tested negative for respiratory viruses using a direct immunofluorescence assay. Their NPA and saliva specimens were additionally tested using multiplex PCR. In these patients, the concordance rate by multiplex PCR between NPA and saliva was 83.8%. Multiplex PCR detected viruses in saliva samples from 16 patients, of which nine (56.3%) had at least one virus that was not detected in the NPA. Decisions on antiviral or isolation precautions would be affected by salivary testing in six patients. Although NPAs have high viral loads and remain the specimen of choice for most patients with respiratory virus infections, supplementary molecular testing of saliva can improve the clinical management of these patients.

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Salivary Detection of H1N1 Virus: A Clinical Feasibility Investigation

Cited by 26 publications

References 23 publications

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox – An animal model of smallpox

Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox – An animal model of smallpox

Comparison between Saliva and Nasopharyngeal Swab Specimens for Detection of Respiratory Viruses by Multiplex Reverse Transcription-PCR

Additional molecular testing of saliva specimens improves the detection of respiratory viruses

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