The role of serologic testing for Zika virus infection

Direct detection of Zika virus (ZIKV) nucleic acid with nucleic acid tests is definitive laboratory evidence of infection. Initial studies suggest that the ZIKV viremic period is limited, leading the Centers for Disease Control and Prevention to recommend that nucleic acid tests be utilized only up to 14 days postsymptom onset in serum and urine. The host immune response to flaviviruses, including to ZIKV, primarily targets the viral envelope (E) protein, which has three main domains (ED I–III). Recent studies suggest that neutralizing antibodies against the EDIII domain are relatively specific and potentially able to discriminate between ZIKV and dengue virus, which share 29% amino acid homology at that region. Comparatively, neutralizing antibodies to EDI and EDII, with amino acid homologies of 35 and 51% between these two viruses, respectively, are highly cross-reactive and likely responsible for the nonspecific reactions observed in the respective serologic assays. The current article describes the humoral immune response to ZIKV, reviews serologic assays for detection of antibodies to ZIKV, discusses performance characteristics of commercially available tests, and summarizes the strengths and limitations of currently available serologic methods. Assays examined in the review include the Centers for Disease Control and Prevention Zika IgM antibody capture ELISA, InBios ZIKV Detect IgM Capture ELISA, DiaSorin, LIAISON XL Zika Capture IgM Assay, Euroimmun anti-ZIKV IgM E...
Source: Reviews in Medical Microbiology - Category: Microbiology Tags: Virology Source Type: research