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Identification of Serologic Markers for School-Aged Children With Congenital Rubella Syndrome.

Hyde, Terri B; Sato, Helena Keico; Hao, LiJuan; Flannery, Brendan; Zheng, Qi; Wannemuehler, Kathleen; Ciccone, Flávia Helena; de Sousa Marques, Heloisa; Weckx, Lily Yin; Sáfadi, Marco Aurélio; de Oliveira Moraes, Eliane; Pinhata, Marisa Mussi; Olbrich Neto, Jaime; Bevilacqua, Maria Cecilia; Tabith Junior, Alfredo; Monteiro, Tatiana Alves; Figueiredo, Cristina Adelaide; Andrus, Jon K; Reef, Susan E; Toscano, Cristiana M; Castillo-Solorzano, Carlos; Icenogle, Joseph P.
J Infect Dis; 212(1): 57-66, 2015 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-25362195

BACKGROUND:

Congenital rubella syndrome (CRS) case identification is challenging in older children since laboratory markers of congenital rubella virus (RUBV) infection do not persist beyond age 12 months.

METHODS:

We enrolled children with CRS born between 1998 and 2003 and compared their immune responses to RUBV with those of their mothers and a group of similarly aged children without CRS. Demographic data and sera were collected. Sera were tested for anti-RUBV immunoglobulin G (IgG), IgG avidity, and IgG response to the 3 viral structural proteins (E1, E2, and C), reflected by immunoblot fluorescent signals.

RESULTS:

We enrolled 32 children with CRS, 31 mothers, and 62 children without CRS. The immunoblot signal strength to C and the ratio of the C signal to the RUBV-specific IgG concentration were higher (P < .029 for both) and the ratio of the E1 signal to the RUBV-specific IgG concentration lower (P = .001) in children with CRS, compared with their mothers. Compared with children without CRS, children with CRS had more RUBV-specific IgG (P < .001), a stronger C signal (P < .001), and a stronger E2 signal (P ≤ .001). Two classification rules for children with versus children without CRS gave 100% specificity with >65% sensitivity.

CONCLUSIONS:

This study was the first to establish classification rules for identifying CRS in school-aged children, using laboratory biomarkers. These biomarkers should allow improved burden of disease estimates and monitoring of CRS control programs.