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A Combination of Serological Assays to Detect Human Antibodies to the Avian Influenza A H7N9 Virus
Authors:Libo Dong  Hong Bo  Tian Bai  Rongbao Gao  Jie Dong  Ye Zhang  Junfeng Guo  Shumei Zou  Jianfang Zhou  Yun Zhu  Li Xin  Xiaodan Li  Cuiling Xu  Dayan Wang  Yuelong Shu
Institution:National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China.; Center for Biologics Evaluation and Research, United States of America,
Abstract:Human infection with avian influenza A H7N9 virus was first identified in March 2013 and represents an ongoing threat to public health. There is a need to optimize serological methods for this new influenza virus. Here, we compared the sensitivity and specificity of the hemagglutinin inhibition (HI), microneutralization (MN), and Western blot (WB) assays for the detection of human antibodies against avian influenza A (H7N9) virus. HI with horse erythrocytes (hRBCs) and a modified MN assay possessed greater sensitivity than turkey erythrocytes and the standard MN assay, respectively. Using these assays, 80% of tested sera from confirmed H7N9 cases developed detectable antibody to H7N9 after 21 days. To balance sensitivity and specificity, we found serum titers of ≥20 (MN) or 160 (HI) samples were most effective in determining seropositive to H7N9 virus. Single serum with HI titers of 20–80 or MN titer of 10 could be validated by each other or WB assay. Unlike serum collected from adult or elderly populations, the antibody response in children with mild disease was low or undetectable. These combinations of assays will be useful in case diagnosis and serologic investigation of human cases.
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