The value of IgG to IgM ratio in predicting secondary dengue infection
Keywords:
dengue hemorrhagic fever (DHF), primary and secondary infection, hemagglutination inhibition (HI) test, ratio of IgG, IgM
Abstract
Background The determination of primary or secondary dengueinfection using hemagglutination inhibition (HI) test is time-con-
suming. The IgG to IgM ratio which can be obtained earlier was
used by several studies to differentiate secondary from primary
infection, but they still reported various cut-off points.
Objective To find the diagnostic value and best cut off point of
IgG to IgM ratio for predicting secondary dengue infection.
Methods This was a prospective study carried out between July
2003 and June 2004. Children with suspected dengue hemor-
rhagic fever (DHF) were tested for HI during acute and convales-
cent phase. The IgG and IgM titer were examined during the acute
phase using ELISA method.
Results Sixty-two children were recruited, 48 with secondary in-
fection and 14 with primary infection. The prevalence of second-
ary infection was 77%. The best cut off point of the IgG to IgM ratio
to predict secondary infection was >1.1 with sensitivity of 87.5%,
specificity 92.9%, likelihood ratio 12.3, and post test probability
97.7%.
Conclusion The IgG to IgM ratio of >1.1 is a good predictor for
secondary infection
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(DBD) di Indonesia saat ini. In: Sri Rezeki, Hindra
Irawan Satari, editors. Demam berdarah dengue.
Naskah lengkap pelatihan bagi pelatih, dokter
spesialis anak, dan dokter spesialis penyakit dalam,
dalam tatalaksana DBD. Jakarta: BP FKUI, 2002. p.
14-31.
2. Chairulfalah A, Setiabudi D, Ridad A, Colebunders
R. Clinical of dengue haemorrhagic fever in children
in Bandung, Indonesia. Ann Soc Belge Med Trop
1995;75:291-5.
3. Darmowandono W. Correlation between humoral im-
mune response and the severity of dengue hemorrhagic
fever. Proceeding of the international seminar on den-
gue fever/dengue hemorrhagic fever in South East Asia.
Surabaya: Tropical center disease, 1999. p. 68-75.
4. Suroso T. Pencegahan dan penanggulangan demam
berdarah dengue (DBD) di masyarakat. Presented at
11th National Child Health Congress, Jakarta; 1999.
5. Sumarmo. The epidemiology control and prevention
of dengue hemorrhagic fever (DHF) in Indonesia.
Cermin dunia kedokteran 1994;92:5-10.
6. Pinheiro FP, Chuid R, WHO. Emergence of dengue
hemorrhagic fever in the American. Infect Med
1998;15:244-51.
7. Usawattanakul W, Nimmantya S, Sarabenjawarong K,
Tharavanij S. Endotoxin and dengue hemorrhagic fe-
ver. Southeast Asian J Trop Med 1996;17:8-12.
8. Sutaryo. Perkembangan patogenesis demam berdarah
dengue. Dalam: Sri Rezeki, Hindra Irawan Satari, edi-
tors. Demam berdarah dengue. Naskah lengkap
pelatihan bagi pelatih, dokter spesialis anak, dan dokter
spesialis penyakit dalam, dalam tatalaksana DBD.
Jakarta: BP FKUI, 2002. p. 32-43.
9. Behrman RE, Kliegman RM, Nelson WE, Vaughan VC.
The nervous system. In: Behrman RE, Kliegman RM,
editors. Nelson Textbook of Pediatrics. 15th ed. Phila-
delphia: W.B. Saunders Company, 1997. p. 11-23.
10. Innis BL, Nisalak S, Nimmannitya S, Kusalerdchariya
S, Chongswasdi V, Suntayakorn S, et al. An enzyme-
linked immunosorbent assay to characterize dengue
infections where dengue and Japanese encephalitis co-
circulate. Am J Trop Med Hyg 1989;40:418-27.
11. Martinez E, Guzman MG, Valdes M, Soler M, Kouri
G. Dengue and dengue hemorrhagic fever in infants
with a primary infection. Rev Cubana Med Trop
1993;45:97-101.
12. Sutaryo. Dengue. 1st ed. Yogyakarta: Medika Fakultas
Kedokteran Unversitas Gajah Mada, 2004. p. 1-241.
13. Pei YS, Li KC, Shu FC, Yi YY, Ling Chow, Li JC, et al.
Comparison of capture imunoglobulin M (IgM) and IgG
enzym-linked immunoabsorbent assay (ELISA) and
nostructural protein NS1 serotype-specific IgG ELISA
for diffrentiation of primary and secondary dengue virus
infections. J Clin Immunol 2003;10:622-30.
14. Vaughan DW, Green S, Kalanarooj S, Innis BL,
Nimmannitya, Suntayakorn, et al. Dengue in the early
febrile phase: Viremia and antibody responses. J Infect
Dis 1997;176:322-36.
15. Koroka P, Suharti C, Setiati E, Mairuhu ATA, Van Gorp
E, Hack CE, et al. Kinetics of dengue-specific serum im-
munoglobulin classes and subclasses correlate with clini-
cal outcome infection. J Clin Microbiol 2001;39:4332-8.
Published
2016-10-18
How to Cite
1.
Karyana IP, Santoso H, Arhana BN. The value of IgG to IgM ratio in predicting secondary dengue infection. PI [Internet]. 18Oct.2016 [cited 6May2024];46(3):113-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/911
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Received 2016-10-13
Accepted 2016-10-13
Published 2016-10-18
Accepted 2016-10-13
Published 2016-10-18
