Summary
The total rubella IgG antibody avidity ELISA, as described byHedmann [8] for differentiation between acute primary rubella and reinfection, persisting or non-specific IgM antibodies were evaluated in 212 sera of four categories of patients with known history (n=149) and in one group (n=39) of patients with a history of unclear nature. The development of the IgG ratio (avidity) from low (<30%) to higher levels (>30%) was determined in 146 sera from 96 cases with acute primary rubella between days 1 to 256 after onset of exanthem, with a borderline between low (<30%) and high (>30%) avidity after four weeks after onset of exanthem. From seven days to 14 years following vaccination, the IgG ratio increased more slowly following vaccination, with a useful borderline at 2 1/2 months. In 80 sera from 13 women with reinfection during pregnancy, six infants with rubella embryopathy, and 19 pregnant women with rubella IgM antibodies detected during antenatal screening, the total IgG ratio ranged between 48% and 100%, indicating a previous infection. The diagnostic value of the IgG subclass-specific antibody avidity assay was investigated in 40 of the 251 sera. The results confirmed those of the total IgG avidity assay. Both tests are of additional help for differentiating serologically primary rubella from reinfection or recent from previous vaccination.
Zusammenfassung
Der Avidity-ELISA für Röteln-Gesamt-IgG [8] zur Differenzierung von akuten primären Röteln, Röteln-Reinfektion, persistierenden oder nichtspezifischen IgM-Antikörpern für die Diagnose von Rötelnproblemfällen wurde anhand von 212 Seren von vier Kategorien untersucht. Die Entwicklung der IgG-Ratio (avidity) von niedrigen (<30%) zu höheren (>30%) Werten wurde mit 146 Seren von 96 Fällen mit akuten primären Röteln entnommen zwischen 1 und 256 Tagen nach Ausbruch des Rötelnexanthems bestimmt. Die Grenze zwischen niedrigen (<30%) und hohen Ratios (>30%) lag bei vier Wochen nach Exanthembeginn. In 32 Seren von 23 Impflingen mit Serumentnahme zwischen sieben Tagen und 14 Jahren nach Impfung stiegen die IgG-Ratios langsamer an, mit einer nützlichen Grenze bei 2 1/2 Monaten. In 80 Seren von 13 schwangeren Frauen mit Reinfektion während der Schwangerschaft, sechs Kindern mit Rötelnembryopathie und 19 Schwangeren mit IgM-Antikörperbefunden bei Untersuchung in der Mutterschaftsvorsorge bewegte sich die IgG-Ratio zwischen 48% und 100% als Hinweis auf frühere Infektion. Der diagnostische Wert des IgG-Subklassen-spezifischen Avidity-Assays wurde anhand von 40 der 251 untersuchten Seren bestimmt. Dessen Ergebnisse bestätigten die Befunde mit dem Gesamt-IgG-Antikörper-Avidity-Assay. Beide Teste geben eine zusätzliche Absicherung für die serologische Differenzierung von primärer akuter Infektion und Reinfektion bzw. von kürzlicher zu früherer Impfung.
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Enders, G., Knotek, F. Rubella IgG total antibody avidity and IgG subclass-specific antibody avidity assay and their role in the differentiation between primary rubella and rubella reinfection. Infection 17, 218–226 (1989). https://doi.org/10.1007/BF01639523
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DOI: https://doi.org/10.1007/BF01639523