Evaluation of a Commercial Capture Enzyme-Linked Immunosorbent Assay for Detection of Immunoglobulin M and G Antibodies Produced during Dengue Infection

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Abstract
A commercially available capture enzyme-linked immunosorbent assay (ELISA) for the detection of specific immunoglobulin M (IgM) and IgG antibodies produced during dengue infection (PanBio Dengue Duo) was evaluated with paired serum specimens from 176 patients. Diagnosis was based on a hemagglutination inhibition (HAI) assay, with patients having either primary dengue ( n = 90), secondary dengue ( n = 58), or no dengue ( n = 28) infection. The combined use of IgM and IgG (sensitivity, 99%; specificity, 96%) was superior to the use of IgM alone (sensitivity, 88%; specificity, 96%) or IgG alone (sensitivity, 85%; specificity, 96%). Furthermore, with the first serum sample of the pair of serum samples, the ELISA was able to diagnose significantly more cases of dengue than the HAI assay (55% versus 14%). The results of the IgG capture ELISA gave a significant correlation with those of the HAI assay ( r = 0.91; P < 0.0001), and the IgG capture ELISA could be used to distinguish between primary and secondary infection. The best distinction was observed when an IgG cutoff ratio of 3.0 was used, with 88% of primary infections and 98% of secondary infections being correctly classified. This ELISA should prove to be useful in the clinical diagnosis of dengue infection.