Journal of Clinical Virology最新文献

{"title":"Design and performance of a real-time RT-PCR assay for detection of influenza C viruses","authors":"Bo Shu ,&nbsp;William G. Davis ,&nbsp;Ji Liu ,&nbsp;Beth K. Thielen ,&nbsp;Sarah Bistodeau ,&nbsp;Brian Lynch ,&nbsp;Christine M. Warnes ,&nbsp;Jimma Liddell ,&nbsp;Anna K. Strain ,&nbsp;Jaime Christensen ,&nbsp;Phili Wong ,&nbsp;Natasha Burnett ,&nbsp;Todd C. Davis ,&nbsp;Marie K. Kirby","doi":"10.1016/j.jcv.2025.105874","DOIUrl":"10.1016/j.jcv.2025.105874","url":null,"abstract":"<div><div>Influenza C virus (ICV) usually causes a mild upper respiratory tract infection in children and those infected are frequently co-infected with other respiratory viruses. However, there have only been a few hundred documented cases of ICV infection in humans as of the end of 2024. To better understand the epidemiology and clinical impact of ICVs, we developed an influenza C real-time RT-PCR (InfC rRT-PCR) assay that targets a highly conserved region of the matrix gene segment of ICVs. The analytical sensitivity evaluation demonstrated that the InfC rRT-PCR assay was highly sensitive, as it was able to detect as few as five RNA copies per PCR reaction and had robust reactivity over a range of viral RNAs from historical and recent ICVs. The analytical specificity evaluation confirmed the assay did not cross-react with any influenza A or B viruses tested, including several animal-origin viruses, or other common non-influenza respiratory viruses. The performance evaluation on clinical specimens demonstrated the assay was highly sensitive and specific for the detection of ICVs.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105874"},"PeriodicalIF":3.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing B19V epidemiology and viremia dynamics in plasma donors: A comprehensive analysis","authors":"Martin Wälti ,&nbsp;Marco Natali ,&nbsp;Adrian Sanden ,&nbsp;Remo Leisi ,&nbsp;Svenja Rohde ,&nbsp;Rick Alexander ,&nbsp;Jonas Sieber ,&nbsp;Christoph Zürcher ,&nbsp;Björn Keiner ,&nbsp;Kelley Hyatt ,&nbsp;Eva Quinley ,&nbsp;Joyce Castaneda ,&nbsp;Michael Schiffer ,&nbsp;Denis Klochkov ,&nbsp;Eleonora Widmer","doi":"10.1016/j.jcv.2025.105873","DOIUrl":"10.1016/j.jcv.2025.105873","url":null,"abstract":"<div><h3>Background</h3><div>Parvovirus B19 (B19V) infection is characterized by measurable bloodstream biomarkers, which vary over time indicating different phases of infection. High B19V DNA levels in the bloodstream are associated with infectivity, impacting the eligibility of source plasma donors.</div></div><div><h3>Objectives</h3><div>Characterize temporal changes in B19V epidemiological rates from January 2018 to April 2025 and to investigate the longitudinal dynamics of the diagnostic biomarkers and infectivity in subclinical infections among US source plasma donors.</div></div><div><h3>Results</h3><div>B19V positivity rates in CSL’s US source plasma donors decreased to a very low level during the COVID-19 pandemic and until Spring 2023 and re-emerged in two waves with peak rates ≥ 2.2-fold higher compared to pre-COVID data (2018 – 2020). During the exponential infection phase, B19V DNA doubled every 3–5 h, leading to high titers up to 10^12 IU/mL and peak infectivity of ∼10^8 TCID₅₀/mL. Infectivity ceased when anti-B19V IgG reached a plateau or 14 days after DNA titer dropped below 4.8 × 10^5 IU/mL.</div></div><div><h3>Conclusions</h3><div>The re-emergence of B19V with high positivity rates highlights the relevance of donation testing for plasma. During the month from infection onset, B19V DNAemia correlates well with the measured infectious titer. B19V infectivity in plasma disappears within a month while DNA can persist in the plasma in absence of detectable infectivity, likely due to the immune response as characterized by the immunological markers.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105873"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndromic approach for rapid detection and differentiation of human pathogenic alphaviruses","authors":"Carlo Fischer ,&nbsp;Anges Yadouleton ,&nbsp;Miguel Mauricio Cabada ,&nbsp;Miladi Gatty Nogueira ,&nbsp;Marta Piche-Ovares ,&nbsp;Stephane Sohou ,&nbsp;César Augusto Cabezas Sánchez ,&nbsp;Patricia T. Bozza ,&nbsp;María Paquita García Mendoza ,&nbsp;Eduardo Gotuzzo ,&nbsp;Fernando Augusto Bozza ,&nbsp;Jan Felix Drexler","doi":"10.1016/j.jcv.2025.105872","DOIUrl":"10.1016/j.jcv.2025.105872","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge of epidemiology, pathogenesis, and public health burden is scarce for many arthropod-borne viruses (arboviruses). Insufficient knowledge is partly attributable to the lack of exhaustive laboratory diagnostics due to resource limitations. Among arboviruses, arthritogenic and encephalitogenic alphaviruses are globally widespread, can cause severe disease, and can co-occur regionally.</div></div><div><h3>Objectives</h3><div>We developed and validated a multiplexed real-time reverse transcription-PCR assay for the detection of all alphaviruses commonly causing human disease except Barmah Forest virus.</div></div><div><h3>Study design</h3><div>The assay combines five antigenic complex-specific assays and one Chikungunya virus (CHIKV)-specific assay in a single parallelized reaction.</div></div><div><h3>Results</h3><div>Comparisons with previously published PCR-based protocols for broad alphavirus detection using 20 different human-pathogenic alphaviruses revealed a significantly higher sensitivity of the new multiplexed assay (Fisher’s exact test, p &lt; 0.0001). Detection limits with the new assay ranged from 0.83 cps/μl of extracted O’nyong-nyong virus to 33.05 cps/μl of extracted Western equine encephalitis virus. Antigenic complexes could be clearly differentiated by reactivity, Ct values (<em>t</em>-test, p &lt; 0.0025) and signal intensities (<em>t</em>-test, p &lt; 0.0001), even when testing high alphavirus concentrations potentially capable of causing false-positive PCR results. Testing of high-titred cell culture supernatants of eight important non-alphaviral arboviruses, of 4308 serum samples collected from febrile patients in Benin and Peru, of seven CHIKV-positive diagnostic samples from Brazil, and of non-targeted alphaviruses confirmed excellent diagnostic performance by the new assay, including improved detection of CHIKV, Mayaro and Venezuelan equine encephalitis virus in clinical specimens.</div></div><div><h3>Conclusions</h3><div>Short turn-around time, applicability in resource-limited settings, antigenic complex determination, and higher sensitivity compared to previously available tests make the new assay a useful tool for alphavirus surveillance and routine patient diagnostics.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105872"},"PeriodicalIF":3.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large spatial variation of intrahepatic HDV RNA levels without association with HBV core or S RNA levels in HDV cirrhosis patients","authors":"Gustaf E. Rydell ,&nbsp;Lucia Gonzales Strömberg ,&nbsp;Johan Ringlander ,&nbsp;Maria E. Andersson ,&nbsp;Catarina Skoglund ,&nbsp;Joakim Bedner Stenbäck ,&nbsp;Staffan Nilsson ,&nbsp;Maria Castedal ,&nbsp;Magnus Lindh","doi":"10.1016/j.jcv.2025.105871","DOIUrl":"10.1016/j.jcv.2025.105871","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to investigate correlations between levels of intrahepatic HDV RNA, HBV RNA and corresponding serum markers in patients who underwent transplantation because of HDV-induced liver disease.</div></div><div><h3>Methods</h3><div>10 pieces of tissue from each of five liver explants from patients that underwent transplantation because of HDV-induced liver disease were analyzed by digital droplet PCR.</div></div><div><h3>Results</h3><div>A large variation of the tissue levels of viral RNA was found both between and within patients. Overall, tissue levels of HBV core and S RNA were positively associated. However, no consistent association was observed between tissue levels of HDV RNA and either core or S RNA, except in one patient. Furthermore, intrahepatic HDV RNA levels did not correlate with serum HDV RNA. Instead, serum HDV RNA showed a positive correlation with serum HBsAg, a trend towards correlation with tissue HBV S RNA and a significant correlation with core RNA levels.</div></div><div><h3>Conclusions</h3><div>The results suggest that intrahepatic HBsAg might be a limiting factor for HDV particle secretion, but do not support the hypothesis that HDV suppresses HBV replication.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105871"},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of HIV-1 drug resistance in RNA and proviral DNA genotyping is variable both longitudinally and during repeat testing","authors":"Michelle L. D'Antoni ,&nbsp;Kristen Andreatta ,&nbsp;Silvia Chang ,&nbsp;Kirsten White ,&nbsp;Hui Liu ,&nbsp;Yongwu Shao ,&nbsp;Jason T. Hindman ,&nbsp;Laurie A. VanderVeen ,&nbsp;Christian Callebaut","doi":"10.1016/j.jcv.2025.105870","DOIUrl":"10.1016/j.jcv.2025.105870","url":null,"abstract":"<div><h3>Background</h3><div>HIV-1 variants harboring resistance-associated mutations (RAMs) can be archived in viral reservoirs and then re-emerge. Given the dynamic properties of the latent reservoir and detection limits of genotypic assays, RAM persistence over time is incompletely understood.</div></div><div><h3>Objective</h3><div>This retrospective analysis investigated RAM detection in adults with HIV.</div></div><div><h3>Study design</h3><div>Genotyping of protease, reverse transcriptase, and integrase from 3 bictegravir/emtricitabine/tenofovir alafenamide switch studies was included. Longitudinal analyses were performed for participants with combinations of RNA and proviral DNA genotype reports from ≥2 pre-switch timepoints. Reported RAMs assessed at 2 timepoints were categorized as 100 % or 50 % detection, and those assessed at ≥3 timepoints as persistent, lost, gained, or inconsistent detection. From each whole blood sample, reproducibility (%) of proviral RAM reporting was the number of times the mutation was detected per number of assays run (2–4 replicates).</div></div><div><h3>Results</h3><div>In 223 participants, of 262 RAMs tracked longitudinally over 2 timepoints, 39 % (103/262) had 100 % detection and 61 % (159/262) had 50 % detection, with 64 % (101/159) detected at timepoint 2. In 25 participants with ≥3 timepoints, detection of 57 RAMs was categorized as persistent (19 %; 11/57), lost (12 %; 7/57), gained (26 %; 15/57), or inconsistent (42 %; 24/57). Mean (standard deviation) reproducibility of proviral RAM detection at 1 timepoint was 80.9 % (27.2 %) (336 RAMs from 70 participants).</div></div><div><h3>Conclusions</h3><div>No consistent pattern of longitudinal RAM detection was observed. Reproducibility of proviral genotyping was high but variable. Since RAMs were not always consistently detected, an individual’s cumulative resistance history should be considered for optimal treatment management.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105870"},"PeriodicalIF":3.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing sample adequacy and clinical performance of self-collected and clinician-collected HPV specimens using internal control Ct values","authors":"Marianna Martinelli ,&nbsp;Sadaf Sakina Hassan ,&nbsp;Emel Yilmaz ,&nbsp;Camilla Lagheden ,&nbsp;Sara Nordqvist Kleppe ,&nbsp;Clementina Cocuzza ,&nbsp;Laila Sara Arroyo Mühr","doi":"10.1016/j.jcv.2025.105869","DOIUrl":"10.1016/j.jcv.2025.105869","url":null,"abstract":"<div><h3>Background</h3><div>Human papillomavirus (HPV) testing is the primary method for cervical cancer screening, but reliable detection depends on adequate sample cellularity. Cycle threshold (Ct) values for the assay’s internal control (IC), such as β-globin, are commonly used as proxies for adequacy, yet standardized Ct cut-offs are lacking. We aimed to contribute evidence-based thresholds for sample adequacy using real-world data.</div></div><div><h3>Methods</h3><div>We analyzed 237,853 clinician-collected and self-collected samples tested with the BD Onclarity™ HPV Assay between 2022 and 2024. β-globin Ct values were assessed by HPV status to evaluate adequacy. Histologically confirmed CIN2+ outcomes were linked via the National Cervical Screening Registry to assess clinical performance.</div></div><div><h3>Results</h3><div>Among 110,482 clinician-taken samples, 73.63 % (81,350) were HPV negative; 74.32 % (60,457) of these had β-globin Ct ≤28, and only 1.28 % exceeded Ct 32.1. In 127,390 self-collected samples, 83.47 % (106,329) were HPV negative; 99.66 % (105,967) had Ct ≤28 and only 0.06 % exceeded Ct 32.1. HPV positivity declined gradually beyond Ct 26 and more markedly above Ct 28. CIN2+ cases (n = 5546) were rarely HPV negative (n = 73), and these showed low β-globin Ct values, indicating adequate cellularity. Self-collected samples had significantly lower Ct values than clinician-taken ones (median 21.5 vs. 26.5; p &lt; 2.2e-16), likely due to lower resuspension volume.</div></div><div><h3>Conclusions</h3><div>Both clinician- and self-collected samples showed adequate cellularity, with potentially false negative HPV results from low cellular content appearing rare. Observed patterns suggest Ct &lt;26 as optimal and Ct &lt;28 as a minimum for program-level quality assurance with the BD Onclarity™ HPV Assay.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105869"},"PeriodicalIF":3.4,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Epstein–Barr virus infection in preadolescent children: A prospective study","authors":"Laurel E. Cederberg ,&nbsp;Jennifer M. Geris ,&nbsp;Mee Chang ,&nbsp;Arianna L. Stancari ,&nbsp;Andrew J. Klump ,&nbsp;Lawrence M. Condon ,&nbsp;Gabriel C. Cederberg ,&nbsp;Henry H. Balfour Jr.","doi":"10.1016/j.jcv.2025.105859","DOIUrl":"10.1016/j.jcv.2025.105859","url":null,"abstract":"<div><h3>Importance</h3><div>Epstein–Barr virus (EBV) is not only the principal cause of infectious mononucleosis (IM) but is also a precursor to several cancers and autoimmune disorders. Access to a prophylactic EBV vaccine early in life could be key for the prevention of these conditions. However, the incidence of primary EBV infection (pEBV) in preadolescent children is not currently known. We hypothesized that pEBV is clinically significant, but often undiagnosed.</div></div><div><h3>Methods</h3><div>In this prospective study we screened and followed preadolescent children ages 1.5–11.99 years at a single pediatric primary care clinic to determine incidence of pEBV. Using oral swabs to collect gingival crevicular fluid, we screened participants for the presence of EBV IgG antibody against viral capsid antigen. Participants who lacked EBV antibody (EBV-naïve) were enrolled in the prospective arm of the study with screening for oral EBV antibody every 3 months.</div></div><div><h3>Results</h3><div>Of 291 children screened, 210 (72.2 %) were EBV-naïve. Of those, 181 (86 %) were enrolled in the prospective study. During 119.8 person-years of participant observation, 11 cases of pEBV were documented. Five cases were symptomatic. The incidence of pEBV was 9.2 cases/100 person-years. Self-identified Asian, Black, and Latino children had greater incidence of pEBV relative to self-identified White children.</div></div><div><h3>Conclusions</h3><div>We show that the incidence of pEBV in preadolescents is higher than that of other infectious diseases with disease burdens so severe that vaccines have been used for decades to prevent their spread, but diagnosis of pEBV is often missed by parents and clinicians. This study provides a rationale to administer EBV vaccine to preadolescents. EBV is the only infectious agent assessed in the study.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105859"},"PeriodicalIF":3.4,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of cytomegalovirus cell-mediated immunity assays in the healthy Singapore cohort and challenges of test validation","authors":"Soon Hwee Ng ,&nbsp;Shireen Yan Ling Tan ,&nbsp;Su Ming Thean ,&nbsp;Poi Wah Kwek ,&nbsp;Qirong Yang ,&nbsp;Ya Yun Lim ,&nbsp;Wee Ching Ng ,&nbsp;Terrence Yi Shern Kee ,&nbsp;Ian Tatt Liew ,&nbsp;Shimin Jasmine Chung ,&nbsp;Wei Yee Wan","doi":"10.1016/j.jcv.2025.105858","DOIUrl":"10.1016/j.jcv.2025.105858","url":null,"abstract":"<div><h3>Background</h3><div>Cytomegalovirus (CMV) is a major cause of morbidity and mortality for transplant and immunocompromised patients. While cell-mediated immunity (CMI) is crucial for control of CMV and can influence the management of patients, commercial kits to measure CMI responses have only recently become available. In this study, we evaluated 2 different test kit platforms to determine their performance with the aim of implementing CMV-CMI testing to serve local needs.</div></div><div><h3>Materials</h3><div>Fresh blood samples from healthy volunteers (27 CMV-IgG positives and 10 CMV-IgG negatives) were used to evaluate the performance of CMV Interferon-gamma assays, an ELISA and an ELISpot-assay (ES-a).</div></div><div><h3>Results</h3><div>Specificity was 100 % for both assays, while sensitivity was 66.67 % and 88.89 % respectively for ELISA and ES-a. For the ELISA, the mean coefficient of variations (CV) for within-run and between-run precisions were 3.8 % (1.4–7.3 %) and 15.5 % (5.6–24.7 %), respectively. The mean CV for ES-a’s within-run precisions was 14 % (7.9–21.8 %), though it was not feasible to evaluate between-run precision as blood samples collected on different days from healthy volunteers may have variable results. For ES-a, both delayed blood processing and seeding of peripheral blood mononuclear cells (PBMCs) at lower densities resulted in reduced spot counts but did not affect the qualitative interpretations.</div></div><div><h3>Conclusions</h3><div>ES-a had better sensitivity compared to ELISA in our healthy cohort. Challenges faced in evaluating these assays comprised of the need for fresh blood sample and large blood volume, particularly for ES-a. Such challenges need to be considered during the implementation of similar tests for diagnostic use.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"181 ","pages":"Article 105858"},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic insights from the 2024 West Nile Virus outbreak in Israel: Emphasizing the utility of molecular testing over serology","authors":"Victoria Indenbaum ,&nbsp;Or Kriger ,&nbsp;Zohar Mor ,&nbsp;Efrat Rorman ,&nbsp;Liora Guy David ,&nbsp;Oran Erster ,&nbsp;Danit Sofer ,&nbsp;Ravit Koren ,&nbsp;Shiri Katz Likvornik ,&nbsp;Osnat Halpern ,&nbsp;Enosh Tomer ,&nbsp;Oren Shetach Katabi ,&nbsp;Moran Sharon ,&nbsp;Hila De-Leon ,&nbsp;Sharon Alroy-Preis ,&nbsp;Yaniv Lustig","doi":"10.1016/j.jcv.2025.105857","DOIUrl":"10.1016/j.jcv.2025.105857","url":null,"abstract":"<div><h3>Background</h3><div>In 2024, Israel experienced its largest West Nile Virus (WNV) outbreak, reporting 934 cases. Diagnosis primarily relies on serological testing for IgM antibodies; however, cross-reactivity with other flaviviruses and prolonged IgM persistence complicate interpretation. Molecular testing is less utilized due to concerns about the short duration of viremia and potential false negatives.</div></div><div><h3>Objectives</h3><div>To evaluate the diagnostic reliability and persistence of WNV molecular testing across different sample types compared to serological testing, leveraging the extensive sample collection during the 2024 outbreak in Israel.</div></div><div><h3>Study design</h3><div>Samples from 919 WNV cases, including whole blood (WB), serum, urine, and cerebrospinal fluid (CSF) were evaluated. WNV RNA, IgM antibodies and IgG avidity were tested on all sample types, serum and CSF and serum, respectively.</div></div><div><h3>Results</h3><div>WNV RNA was detected in 91 % of WB samples, and observed up to 52 days post-symptom onset. Detection rates were lower in serum (82 %), urine (71 %), and CSF (53 %), with shorter detection windows. Viral concentrations were highest in urine, followed by WB with serum, and CSF, the lowest. IgM antibodies were present in 83 % of serum and 86 % of CSF samples. RNA detection rates were comparable between hospitals (91 %) and health maintenance organizations (HMOs) (92 %), but IgM positivity was significantly higher in hospitals (91 %) than in HMOs (69 %).</div></div><div><h3>Conclusions</h3><div>Molecular testing on WB offers the highest sensitivity and longest detection window for WNV RNA. Molecular diagnosis enhances accuracy, facilitates earlier detection, and improves clinical and public health response strategies compared to serological diagnosis.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"Article 105857"},"PeriodicalIF":3.4,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of blood pressure indicators and shock indices on hazard of complicated dengue in hospitalized adults with dengue infection","authors":"Baihui Xu ,&nbsp;Tun-Linn Thein ,&nbsp;Zong Min Tay ,&nbsp;Yee-Sin Leo ,&nbsp;David Chien Lye ,&nbsp;Po Ying Chia ,&nbsp;Jue Tao Lim","doi":"10.1016/j.jcv.2025.105855","DOIUrl":"10.1016/j.jcv.2025.105855","url":null,"abstract":"<div><div>Blood pressure monitoring is crucial for early detection of complicated dengue. We investigated the association between blood pressure indicators and complicated dengue hazard over the course of dengue hospitalization in a well-characterized dengue cohort. This study involved 4789 adult dengue patients hospitalized between 2005 and 2008 who did not have complicated dengue (defined as dengue haemorrhagic fever and/or severe dengue) initially. Cases (n = 689) included patients who progressed to complicated dengue during hospitalization, while controls were patients who did not (n = 4100). We used Cox models with time-dependent covariates to estimate hazard ratios for blood pressure indicators' impact on complicated dengue hazard. Additionally, we employed the overlap weighting approach to balance clinical characteristics and conducted subgroup analyses based on age, sex and warning signs. Results indicated that modified shock index (MSI) <span><math><mo>≥</mo></math></span>0.8 was associated with a higher time-averaged hazard in the main cohort (HR: 1.72 [1.36, 2.19], p-value: &lt;0.01). Shock index (SI) ≥0.7 also indicated increased hazard in the main cohort (HR: 1.64 [1.37, 1.95], p-value: &lt;0.01) and among patients without mucosal bleeding (HR: 1.42 [1.19, 1.72], p-value: &lt;0.01). A DBP &lt;60 mmHg led to higher hazards of complicated dengue (HR: 1.45 [1.23, 1.72], p-value: &lt;0.01) in the main cohort. In conclusion, DBP &lt;60 mmHg, shock index <span><math><mo>≥</mo></math></span>0.7 and modified shock index <span><math><mo>≥</mo></math></span>0.8 may be reliable predictors for complicated dengue during hospitalization in adult dengue patients. Clinicians should consider these indices during patient assessment.</div></div>","PeriodicalId":15517,"journal":{"name":"Journal of Clinical Virology","volume":"180 ","pages":"Article 105855"},"PeriodicalIF":3.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}