Performance evaluation of antibody tests for detecting infant respiratory syncytial virus infection.

Jadhao, Samadhan J; Ha, Binh; McCracken, Courtney; Gebretsadik, Tebeb; Rosas-Salazar, Christian; Chappell, James; Das, Suman; Hartert, Tina; Anderson, Larry J

Respiratory syncytial virus (RSV) infection is a major cause of respiratory tract disease in young children and throughout life. Infant infection is also associated with later respiratory morbidity including asthma. With a prospective birth cohort study of RSV and asthma, we evaluated the performance of an RSV antibody enzyme-linked immunoassay (EIA) for detecting prior infant RSV infection. Infant RSV infection was determined by biweekly respiratory illness surveillance plus RSV PCR testing in their first RSV season and serum RSV antibodies after the season at ~ 1 year of age. RSV antibodies were detected by RSV A and B lysate enzyme immunoassay (lysate EIA). Antibody and PCR results on 1707 children included 327 RSV PCR positive (PCR+) and 1380 not RSV+. Of 327 PCR+ children, 314 (96%) were lysate EIA positive and 583/1380 (42%) children not PCR+ were positive. We compared the lysate EIA to RSV F, group A G (Ga), and group B G (Gb) protein antibody EIAs in a subset of 226 sera, 118 PCR+ children (97 group A and 21 group B) and 108 not PCR+. In this subset, 117/118 (99%) RSV PCR+ children were positive by both the F and lysate EIAs and 103/118 (87%) were positive by the Ga and/or Gb EIAs. Comparison of the two G EIAs indicated the infecting group correctly in 100/118 (86%) and incorrectly in 1/118 (1%). The lysate and F EIAs are sensitive for detecting infant infection and the two G EIAs can indicate the group of an earlier primary infection. This article is protected by copyright. All rights reserved.