NS1 detection in addition to reverse transcriptase PCR and transcription-mediated amplification of dengue virus RNA in acutely ill patients.

摘要

We comment on the potential utility of transcription-mediated amplification (TMA) of dengue virus (DENV) RNA in acutely ill patients between 1 and 5 days of the appearance of symptoms. The superiority of TMA to reverse transcriptase PCR (RT-PCR) (1) would be evident not only in a comparison with the DENV immunoglobulin M (IgM) and/or IgG serology profiles (1) but through a concurrent assay of the DENV NS1 antigen response.Studies have attempted to determine the utility of RT-PCR in relation to the appearance of the DENV NS1 antigen. NS1 detection appeared to be better than RT-PCR. For example, DENV NS1 antigen detection in travelers upon arrival at airports in Taiwan was instrumental in the detection of 19 RT-PCR-negative travelers who would have been labeled DENV negative. Two of them turned out to be IgM positive on day 17 or 18 of illness (2). Furthermore, in Malaysia, 42 of 55 patients with a diagnosis of acute dengue were positive for NS1 but negative by both RT-PCR and virus isolation (3).