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
The cross-reactivity among hantaviruses often complicates the interpretation of serology results, especially in areas where different hantaviruses co-circulate.
Data on the comparison of different serologic methods in the diagnosis of hantaviruses are scarce.
This study aimed to analyze the diagnostic value of indirect immunofluorescence (IFA) and western blot (WB) methods in diagnosing hantavirus infections.
A commercial IFA was used to detect immunoglobulin M (IgM)/immunoglobulin G (IgG) antibodies to the most common orthohantaviruses: Puumala (PUUV), Dobrava (DOBV), Hantaan (HTNV), Seoul (SEOV), and Saaremaa (SAAV). Cross-reactive samples were additionally tested by a commercial WB using PUUV, DOBV, and HTNV antigens.
Using IFA, 49.5% of acute-phase serum samples reacted only with the homologous PUUV antigen, while in 50.5% samples, cross-reactive IgM and/or IgG antibodies were found. PUUV IgM/IgG antibodies cross-reacted with HTNV (12.3%/31.5%), SEOV (7.5%/17.8%), DOBV (5.4%/28.1%), and SAAV (4.8%/15.7%). Both DOBV IgM and IgG antibodies were broadly reactive with HTNV (76.2%/95.2%), SAAV (80.9%/83.3%), and SEOV (78.6%/85.7%) and moderate with PUUV (28.5%/38.1%). Using a WB, serotyping was successful in 89.5% cross-reactive samples.
WB seems to be more specific than IFA, confirming hantavirus serotype in the majority of cross-reactive samples detected by IFA.
Further studies on a large sample caused by different hantavirus serotypes are needed.