Sensitivity and specificity of anti-double-stranded RNA immunofluorescence for universal detection of viral infection in respiratory specimens
Kornthara Kawang,
Udsanee Naoudom,
Ekasit Kowitdamrong,
Stephen J. Kerr,
Kiat Ruxrungtham,
Voraphoj Nilaratanakul
Affiliations
Kornthara Kawang
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Interdisciplinary Program of Biomedical Sciences, Graduate School, Chulalongkorn University, Bangkok, 10330, Thailand
Udsanee Naoudom
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
Ekasit Kowitdamrong
Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand; Applied Medical Virology Research Unit, Chulalongkorn University, Bangkok, Thailand
Stephen J. Kerr
Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
Kiat Ruxrungtham
Chulalongkorn Vaccine Research Center (Chula VRC), Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand; Thai Red Cross AIDS Research Centre (TRC-ARC), Thailand
Voraphoj Nilaratanakul
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Healthcare-associated Infection Research Group STAR (Special Task Force for Activating Research), Chulalongkorn University, Bangkok, 10330, Thailand; Corresponding author.
Background: Emerging viruses could be detected before reaching pandemic level if universal viral detection screening was routinely used. Double-stranded RNA (dsRNA) is the only common antigen across most viral families. Anti-dsRNA immunofluorescence has shown promising results in vitro; however, its diagnostic value in respiratory specimens has not been evaluated. Methods: Consecutive inpatient cases of suspected respiratory viral infections were prospectively enrolled. Respiratory samples were collected and divided for anti-dsRNA immunofluorescence (index test) and 19-subtypes respiratory virus microarray (reference standard). Using fluorescence microscopy, positive or negative anti-dsRNA IF results were determined independently by two raters. Results: By microarray, 108 and 87 samples were positive and negative for viruses, respectively. The anti-dsRNA IF sensitivity was 83.3% (95%CI 76.1%–90.2%), while specificity was 87.4% (95%CI 80.8%–93.7%). Conclusions: Anti-dsRNA IF is simple to perform, with acceptable accuracy, and suitable for point-of-care respiratory virus screening. Unlike most molecular techniques, known viral genome sequences are not required.
