We describe here a rapid and semiautomated method for the determination of rubella virus immunoglobulin G (IgG) avidity with the VIDAS instrument. A total of 153 serum samples from persons with naturally acquired rubella virus infections (n ؍ 98), from vaccinated persons (n ؍ 44), and from patients with autoantibodies (n ؍ 11) were included in this study. The rubella virus-specific IgG avidity assay we developed for the VIDAS instrument was evaluated by comparison with an in-house method. Results obtained with the VIDAS instrument allow considering this method valuable to help confirm or exclude acute primary infection or recent vaccination.Thanks to extensive vaccination programs, rubella virus infection has dramatically decreased, especially in developed countries. However, rubella vaccine coverage is not sufficient throughout the world and rubella cases are still reported. As clinical diagnosis is unreliable, laboratory diagnosis is necessary to confirm acute rubella virus infection. This diagnosis is based on the observation of seroconversion or on the detection of both rubella virus-specific immunoglobulin G (RV-IgG) and RV-IgM. Seroconversion is rarely observed and is not sufficient to confirm acute rubella virus infection. Indeed, as the cutoff of rubella tests is relatively high (10 IU/ml or 15 IU/ml), the first serum sample tested can be considered negative for rubella virus antibodies whereas it may contain trace amounts (below the cutoff) of RV-IgG. Under these conditions, "seroconversion" cannot always be related to acute rubella virus infection. In the same way, if RV-IgM is always detected in acute rubella virus infection, it can also be detected for a long time, especially after vaccination, because of polyclonal stimulation of the immune system and also because of reinfection (1,2,6,12,13,14). Among the supplementary tests used to confirm recent primary rubella virus infection, RV-IgG avidity have proved to be very helpful (3,4,5,7,8). Recently, commercial RV-IgG avidity assays have been compared (11). Among the five assays tested, only the Euroimmun and Radim rubella virus IgG avidity assays performed well, demonstrating excellent correlation with the "gold standard" and for this reason were the only ones that were considered reliable. These commercial tests are processed in microplates and need more than 1 h to be completed. The aim of our study was to develop a rapid and semiautomated RV-IgG avidity method for the VIDAS instrument (bioMérieux, Marcy-l'Étoile, France) that allows single-dose testing.
MATERIALS AND METHODSSerum samples. A total of 153 serum samples were included in this RV-IgG avidity study. Ninety-eight samples were collected after naturally acquired rubella virus infection; 19 were from recently acquired infections and were collected between the onset of infection and 1 month after, 5 were collected between 1 and 2 months after the onset of infection, and 74 were collected more than 3 months after the onset of infection (50 were RV-IgG positive and RVIgM negative, and 24...