Comparison of indirect immunofluorescence and western blot method in the diagnosis of hantavirus infections. 2021

Tatjana Vilibic-Cavlek, and Ljubo Barbic, and Vladimir Stevanovic, and Vladimir Savic, and Anna Mrzljak, and Maja Bogdanic, and Irena Tabain
School of Medicine, University of Zagreb, Zagreb 10000, Croatia.

BACKGROUND Serologic cross-reactivity between hantaviruses often complicates the interpretation of the results. OBJECTIVE To analyze the diagnostic value of indirect immunofluorescence assay (IFA) and western blot (WB) in the diagnosis of hantavirus infections. METHODS One hundred eighty-eight serum samples from Puumala (PUUV) and Dobrava (DOBV) orthohantavirus infected patients were analyzed. Serology was performed using commercial tests (Euroimmun, Lübeck, Germany). RESULTS Using IFA, 49.5% of acute-phase samples showed a monotypic response to PUUV, while 50.5% cross-reacted with other hantaviruses. The overall cross-reactivity was higher for immunoglobulin G (IgG) (50.0%) than for immunoglobulin M (IgM) (25.5%). PUUV IgM/IgG antibodies showed low/moderate reactivity with orthohantaviruses Hantaan (12.3%/31.5%), Seoul (7.5%/17.8%), DOBV (5.4%/ 28.1%), and Saaremaa (4.8%/15.7%). Both DOBV IgM and IgG antibodies were broadly reactive with Hantaan (76.2%/95.2%), Saaremaa (80.9%/83.3%), and Seoul (78.6%/85.7%) and moderate with PUUV (28.5%/38.1%). Using a WB, serotyping was successful in most cross-reactive samples (89.5%). CONCLUSIONS The presented results indicate that WB is more specific than IFA in the diagnosis of hantavirus infections, confirming serotype in most IFA cross-reactive samples.

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