Estudo de casos suspeitos de dengue negativos no teste sorol??gico para detec????o do ant??geno NS1: falha no diagn??stico ou emerg??ncia de outras arboviroses?

• Autor(es): Silva, Marineide Souza da
• Data: 2018
• Origem: Oasisbr
• Assunto(s): Arboviroses; V??rus Dengue; Prote??na NS1; V??rus Mayaro; V??rus Oropouche; V??rus Chikungunya; V??rus Zika; CI??NCIAS BIOL??GICAS: IMUNOLOGIA
• Tipo de Documento: Dissertação de mestrado
• Idioma: Português

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FAPEAM - Funda????o de Amparo ?? Pesquisa do Estado do Amazonas

Dengue is currently considered the most important arbovirose. Its main vector is the mosquito Aedes aegypti, present in several regions around the world. The serological diagnosis by means of the NS1 antigen search is the one that has greater applicability, because of easy of execution and the window for detection between the 1st and the 9th day of the onset of symptoms, with a higher frequency until the 5th day. This study aimed to investigate the presence of dengue virus in samples with non-reactive results for the NS1 antigen, assessing if there was a failure in laboratorial diagnosis, or the existence of other arboviruses circulating in the state of Amazonas. Using the RT-qPCR technique, the presence of dengue virus was investigated in 306 serum samples from patients with clinical suspicion of infection. The samples that remained negative were investigated for the presence of the Zika (ZIKV), Chikungunya (CHIKV), Mayaro (MAYV) and Oropouche (OROV) viruses with the same methodology, as well as the presence of IgG and IgM for dengue virus by ELISA. Of the 306 analyzed samples, 17 (5.5%) were positive for DENV, with three sequenced for serotype 4. Thirty-four (10.8%) were positive for ZIKV, one (0.3%) for CHIKV, thirteen 4.2%) for MAYV and nine (2.9%) for OROV. In relation to the NS1 test, all kits evaluated presented 100% agreement in negativity. For the screening of anti-DENV antibodies of the IgG class, of the 306 samples tested 134 (43.8%) had positive results. Regarding the detection of the IgM antibody, different positivities were observed for commercial kits: VIRION (n = 250) 35.6% positive; FOCUS (n = 105) 10.5% positive and PANBIO (N = 80) 20% positive. Our results confirm cases of false negative results for the NS1 tests of three commercial kits, in addition to the circulation of other arboviruses among patients from different municipalities in the state of Amazonas.

A dengue ?? considerada atualmente a mais importante arbovirose. O seu principal vetor ?? o mosquito da esp??cie Aedes aegypti, presente em diversas regi??es do mundo. O diagn??stico sorol??gico por meio da pesquisa do ant??geno NS1 ?? o que tem maior aplicabilidade, pela baixa complexidade na execu????o e por ser detectado entre o 1?? e 9?? dia de in??cio dos sintomas, por??m com frequ??ncia maior at?? o 5?? dia. Esse estudo teve por objetivo principal investigar a presen??a do v??rus dengue em amostras com resultados ???N??o Reagentes??? para o ant??geno NS1, avaliando se houve falha no diagn??stico laboratorial, ou a exist??ncia de outros arbov??rus circulando no estado do Amazonas. Utilizando a t??cnica de RT-qPCR, pesquisou-se a presen??a do v??rus dengue em 306 amostras de soros de pacientes com suspeita cl??nica de infec????o. As amostras que continuaram negativas foram pesquisadas quanto a presen??a dos v??rus Zika (ZIKV), Chikungunya (CHIKV), Mayaro (MAYV) e Oropouche (OROV), pela mesma metodologia, bem como foi pesquisada a presen??a de anticorpos das classes IgG e IgM para o v??rus dengue por ELISA. Das 306 amostras analisadas 17 (5,5%) foram positivas para DENV, com tr??s sequenciadas para o sorotipo 4. Trinta e quatro (10,8%) foram positivas para o ZIKV, uma (0,3%) para CHIKV, treze (4,2%) para MAYV e nove (2,9%) para OROV. Em rela????o ao teste NS1 todos os kits avaliados apresentaram 100% de concord??ncia em negatividade. Para a pesquisa de anticorpos anti-dengue da classe IgG, das 306 amostras testadas 134 (43,8%) tiveram resultados positivos. Em rela????o ?? detec????o do anticorpo IgM foram observadas diferentes positividades para os kits comerciais: VIRION (n=250) 35,6% positivas; FOCUS (n=105) 10,5% positivas e PANBIO (N=80) 20% positivas. Nossos resultados confirmam casos de resultados falso-negativos, para os testes NS1 de tr??s kits comerciais, al??m da circula????o de outros arbov??rus entre os pacientes de diferentes munic??pios do estado do Amazonas.