IgM serological diagnostic
plays an important role in the dengue epidemiological surveillance. However,
IgA has been identified as a possible diagnostic marker for early stage and
recent infections. The aim of this study was to know the IgA response in dengue
patients in relation to type of infection, serotype specificity and role as
early and recent infection marker. IgA behavior in dengue patients, using a method defined as
Indirect
Sandwich ELISA-IgA (ELISA-IgA)
and Capture
IgM ELISA (MAC- ELISA)as reference assay was studied. The sensibility and
specificity of the system were 91.06% and 83.73% respectively. In acute phase
of illness, IgA was only detected in secondary cases with 32.3%. IgM appears later than IgA in secondary
cases. No significant differences in IgA or IgM responses between primary and
secondary cases were found in samples collected after day 5 of onset of
symptoms. In days 41-54, the percentage of IgA was lower respect to IgM. IgA was detected until day47 inprimary and until day50 insecondary cases. An
elevated cross-reactivity in IgA was observed between dengue serotypes contrary
to IgM. The usefulness of IgA, as alternative early diagnostic tool, could be
influenced by the absence or very low percentages of positives cases in the
first four days of onset of symptoms. However, for definition of secondary
infection could be important. IgA could be an alternative tool, better than
IgM, as recent infection marker for dengue fever, but this requires more studies in future investigations.
Cite this paper
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