Antibody-based assay discriminates Zika virus infection from other flaviviruses



Balmaseda, Angel, Stettler, Karin, Medialdea-Carrera, Raquel, Collado, Damaris, Jin, Xia, Zambrana, Jose Victor, Jaconi, Stefano, Cameroni, Elisabetta, Saborio, Saira, Rovida, Francesca
et al (show 13 more authors) (2017) Antibody-based assay discriminates Zika virus infection from other flaviviruses. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 114 (31). pp. 8384-8389.

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Abstract

Zika virus (ZIKV) is a mosquito-borne flavivirus that emerged recently as a global health threat, causing a pandemic in the Americas. ZIKV infection mostly causes mild disease, but is linked to devastating congenital birth defects and Guillain-Barré syndrome in adults. The high level of cross-reactivity among flaviviruses and their cocirculation has complicated serological approaches to differentially detect ZIKV and dengue virus (DENV) infections, accentuating the urgent need for a specific and sensitive serological test. We previously generated a ZIKV nonstructural protein 1 (NS1)-specific human monoclonal antibody, which we used to develop an NS1-based competition ELISA. Well-characterized samples from RT-PCR-confirmed patients with Zika and individuals exposed to other flavivirus infections or vaccination were used in a comprehensive analysis to determine the sensitivity and specificity of the NS1 blockade-of-binding (BOB) assay, which was established in laboratories in five countries (Nicaragua, Brazil, Italy, United Kingdom, and Switzerland). Of 158 sera/plasma from RT-PCR-confirmed ZIKV infections, 145 (91.8%) yielded greater than 50% inhibition. Of 171 patients with primary or secondary DENV infections, 152 (88.9%) scored negative. When the control group was extended to patients infected by other flaviviruses, other viruses, or healthy donors (<i>n</i> = 540), the specificity was 95.9%. We also analyzed longitudinal samples from DENV-immune and DENV-naive ZIKV infections and found inhibition was achieved within 10 d postonset of illness and maintained over time. Thus, the Zika NS1 BOB assay is sensitive, specific, robust, simple, low-cost, and accessible, and can detect recent and past ZIKV infections for surveillance, seroprevalence studies, and intervention trials.

Item Type: Article
Uncontrolled Keywords: Zika, serology, flaviviruses, dengue, ELISA
Depositing User: Symplectic Admin
Date Deposited: 12 Aug 2019 14:05
Last Modified: 19 Jan 2023 00:31
DOI: 10.1073/pnas.1704984114
Open Access URL: https://doi.org/10.1073/pnas.1704984114
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3051542