Evaluation of an immunochromatography rapid diagnosis kit for detection of chikungunya virus antigen in India, a dengue-endemic country

Abstract

BackgroundChikungunya virus (CHIKV) and dengue virus (DENV) are arboviruses that share the same Aedes mosquito vector, and there is much overlap in endemic areas. In India, co-infection with both viruses is often reported. Clinical manifestations of Chikungunya fever is often confused with dengue fever because clinical symptoms of both infections are similar. It is, therefore, difficult to differentiate from those of other febrile illnesses, especially dengue fever. We previously developed a CHIKV antigen detection immunochromatography (IC) rapid diagnosis kit [1]. The current study examined the efficacy of previously mentioned IC kit in India, a dengue-endemic country.MethodsSera from 104 CHIKV-positive (by qRT-PCR) and/or IgM-positive (ELISA) subjects collected in 2016, were examined. Fifteen samples from individuals with CHIKV-negative/DENV-positive and 4 samples from healthy individuals were also examined. Of the 104 CHIKV-positive sera, 20 were co-infected with DENV.ResultsThe sensitivity, specificity and overall agreement of the IC assay were 93.7, 95.5 and 94.3%, respectively, using qRT-PCR as a gold standard. Also, there was a strong, statistically significant positive correlation between the IC kit device score and the CHIKV RNA copy number. The IC kit detected CHIKV antigen even in DENV-co-infected patient sera and did not cross-react with DENV NS1-positive/CHIKV-negative samples.ConclusionsThe results suggest that the IC kit is useful for rapid diagnosis of CHIKV in endemic areas in which both CHIKV and DENV are circulating.Electronic supplementary materialThe online version of this article (10.1186/s12985-018-1000-0) contains supplementary material, which is available to authorized users.

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

“…An immunochromatographic assay using monoclonal antibodies against the E1 protein was developed to detect CHIKV antigen in serum (169), but this test was found to be sensitive only for the ECSA lineage (89%) and not for the Asian lineage (33%) (170). Another antigen capture ELISA reported 96% concordance with real-time RT-PCR results for acute-phase samples from 200 subjects in India (146), and a test for whole CHIKV antigen in acute-phase samples had an overall agreement of 94% with RT-PCR (171). As these assays continue to develop and improve, antigen-based detection may provide rapid methods for CHIKV diagnostic confirmation and expand testing to laboratories without the capacity for molecular methods.…”

Diagnosis and Molecular Characterization of Chikungunya Virus Infections

“…There are commercial immunochromatography antigen detection kits which detect CHIKV with high sensitivity in the early phase (up to 4-5 days after the onset of fever, when blood-enveloping proteins are still present). These tests also have high specificity since no cross-reactions with dengue virus are known to exist, and the method is straightforward and simple and does not require specially trained laboratory personnel [79].…”

Cellular and Molecular Immune Response to Chikungunya Virus Infection

“…It is therefore suggested that the detection of CHIKV RNA and virus isolation from serum samples for diagnostic purposes is done before day 5 pio (Johnson et al, 2016b ), because the chance of false-negative results increases with the decrease in viral load. IgM and IgG antibodies against CHIKV begin to be produced at days 2 pio (Jain et al, 2018 ) and 4 pio (Prince et al, 2015 ), respectively. Stable titers of IgM can be seen in the serum from day 6 pio till around 4 months pio (Prince et al, 2015 ) [and can be detected mostly until 6 months pio (Chua et al, 2017 )], whereas sustained levels of IgG can be present for more than 1 year (Chua et al, 2017 ).…”