Antibody Capture Immunoassay Detection of Japanese Encephalitis Virus Immunoglobulin M and G Antibodies in Cerebrospinal Fluid

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Abstract
IgM and IgG antibodies to Japanese encephalitis virus (JEV) were detected in acute-phase CSF specimens from patients with acute encephalitis by using a solid-phase radioimmunoassay of the antibody capture type (ABC-SPIRA). Of 12 patients with JEV infections subsequently proven by hemagglutination inhibition (HI) serology, 11 had JEV IgM antibodies, as measured by ABC-SPIRA in the 1st CSF specimen (geometric mean titer [GMT], 1:2500) compared with 0 of 8 patients with acute encephalitis proven not to be due to JEV. Specific IgM anti-JEV activity U.mu.g was greater in CSF than in parallel serum specimens in all 11 positive cases by > 4-fold on average (range, 1.4-13). Among 7 patients with broadly reactive HI seroresponses typical of persons previously exposed to other flaviviruses, 6 had high levels of JEV igG antibodies (as measured by ABC-SPIRA) in their acute-phase CSF (GMT, 1:26,000). In 5 patients experiencing their 1st flavivirus infection, JEV IgG antibodies measured by ABC-SPIRA were either absent (1 patient) or weakly reactive (4 patients; GMT, 1:3200). Specific IgG anti-JEV activity was greater in CSF than in parallel serum specimens in 8 of the 9 positive cases measured (range, 1.3- to 24-fold). The ABC-SPIRA approach is well suited for detecting specific antibody activity in CSF.