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Sensitivity and Specificity of Serologic Assays for the Detection of Human Infection with 2009 Pandemic H1N1 Virus in U.S. Populations

tetano

Editor, Senior Moderator
J Clin Microbiol. 2011 Apr 6. [Epub ahead of print]
Sensitivity and Specificity of Serologic Assays for the Detection of Human Infection with 2009 Pandemic H1N1 Virus in U.S. Populations.

Veguilla V, Hancock K, Schiffer J, Gargiullo P, Lu X, Aranio D, Branch A, Dong L, Holiday C, Liu F, Steward-Clark E, Sun H, Tsang B, Wang D, Whaley M, Bai Y, Cronin L, Browning P, Dababneh H, Noland H, Thomas L, Foster L, Quinn CP, Soroka SD, Katz JM.

Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Chinese National Influenza Center, State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Xuanwu District Beijing, China.
Abstract

Swine origin 2009 H1N1 influenza virus has spread globally to cause the first influenza pandemic of the 21(st) century. Serological studies can improve our understanding of the extent of human infection and risk factors associated with transmission of this pandemic virus. The "gold standard" for serodiagnosis of human influenza infection is the detection of seroconversion between acute and convalescent stage samples. However, timing of seroepidemiologic investigations often precludes collection of truly acute phase sera, requiring development of serologic criteria for evaluating convalescent phase sera that optimize detection of true positives and true negatives. To guide seroepidemiologic investigations into the spread of the novel 2009 pandemic H1N1 virus, we characterized serum antibody responses to 2009 H1N1 virus in 87 individuals with confirmed viral infection and 227 non-exposed U.S. individuals using microneutralization (MN) and hemagglutination-inhibition (HI) assays. Sensitivity and specificity were determined for each assay alone, and in combination, for detection of 2009 H1N1-specific antibodies in convalescent sera. Although the HI assay was more specific for detecting antibody to 2009 H1N1, the MN was more sensitive, particularly for detecting low titer seroconversions. A combination of titers (MN ≥40 and HI ≥20) provided highest sensitivity (90%) and specificity (96%) for individuals aged < 60 years and 92% specificity for adults aged ≥60 years for detection of serologically confirmed 2009 H1N1 infections in U.S. populations during the first pandemic waves. These studies provide an approach to optimize timely serologic investigations for future pandemics or outbreaks of novel influenza viruses among humans.

PMID: 21471339 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/21471339
 
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