Published online Nov 20, 2021. doi: 10.5662/wjm.v11.i6.294
Peer-review started: January 2, 2021
First decision: July 8, 2021
Revised: July 16, 2021
Accepted: August 31, 2021
Article in press: August 31, 2021
Published online: November 20, 2021
Serologic cross-reactivity between hantaviruses often complicates the interpre
To analyze the diagnostic value of indirect immunofluorescence assay (IFA) and western blot (WB) in the diagnosis of hantavirus infections.
One hundred eighty-eight serum samples from Puumala (PUUV) and Dobrava (DOBV) orthohantavirus infected patients were analyzed. Serology was perfor
Using IFA, 49.5% of acute-phase samples showed a monotypic response to PUUV, while 50.5% cross-reacted with other hantaviruses. The overall cross-reactivity was higher for immunoglobulin G (IgG) (50.0%) than for immunoglobulin M (IgM) (25.5%). PUUV IgM/IgG antibodies showed low/moderate reactivity with orthohantaviruses Hantaan (12.3%/31.5%), Seoul (7.5%/17.8%), DOBV (5.4%/ 28.1%), and Saaremaa (4.8%/15.7%). Both DOBV IgM and IgG antibodies were broadly reactive with Hantaan (76.2%/95.2%), Saaremaa (80.9%/83.3%), and Seoul (78.6%/85.7%) and moderate with PUUV (28.5%/38.1%). Using a WB, serotyping was successful in most cross-reactive samples (89.5%).
The presented results indicate that WB is more specific than IFA in the diagnosis of hantavirus infections, confirming serotype in most IFA cross-reactive samples.
Core Tip: Serologic cross-reactivity among hantaviruses often complicates the interpretation of the results. The overall cross-reactivity is generally higher for immunoglobulin G antibodies than for immunoglobulin M antibodies. Western blot seems to be a more specific serology method than indirect immunofluorescence assay in the diagnosis of hantavirus infections, confirming serotype in the majority of cross-reactive samples detected by indirect immunofluorescence assay.