TY - JOUR
T1 - The role of antibody indexes in clinical virology
AU - Shamier, Marc C.
AU - Bogers, Susanne
AU - Yusuf, Erlangga
AU - van Splunter, Marloes
AU - ten Berge, Josianne C.E.M.
AU - Titulaer, Maarten
AU - van Kampen, Jeroen J.A.
AU - GeurtsvanKessel, Corine H.
N1 - Publisher Copyright:
© 2021 The Author(s)
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Background: Serological techniques are an essential part of the diagnostic tools used in clinical virology. Among these techniques, antibody indexes are not novel, but do require specific expertise. Their niche has expanded substantially in recent years due to increasing evidence of their performance to diagnose viral infections. Objectives: This narrative review describes the background and clinical applications of antibody indexes. The first objective is to provide an overview of the theoretical background, insights for implementation, limitations and pitfalls. The second objective is to review the available evidence for the diagnostic performance, with a specific focus on viral encephalitis and uveitis. Sources: A comprehensive literature search was performed in PubMed, including original studies and reviews, with no time limit on the studies included. The following search terms were used: antibody index, Goldmann–Witmer coefficient, Reibergram, viral encephalitis, viral uveitis, herpes simplex virus, varicella zoster virus, cytomegalovirus, Epstein–Barr virus, rubella virus, measles virus, enterovirus, influenza virus, flaviviruses. Content: Antibody indexes can support the diagnosis of a spectrum of viral infections in immune privileged sites such as the central nervous system and the eye, through the demonstration of virus-specific intrathecal or intraocular antibody production. This is especially useful in situations where PCR has a lower positivity rate: infections with rapid viral clearance due to natural immunity or treatment and chronic stages of viral infections. Implications: Antibody indexes expand the clinical microbiologist's diagnostic toolbox. Careful interpretation of the results of these assays is crucial and further standardization of methods is required to improve interchangeability of results between laboratories.
AB - Background: Serological techniques are an essential part of the diagnostic tools used in clinical virology. Among these techniques, antibody indexes are not novel, but do require specific expertise. Their niche has expanded substantially in recent years due to increasing evidence of their performance to diagnose viral infections. Objectives: This narrative review describes the background and clinical applications of antibody indexes. The first objective is to provide an overview of the theoretical background, insights for implementation, limitations and pitfalls. The second objective is to review the available evidence for the diagnostic performance, with a specific focus on viral encephalitis and uveitis. Sources: A comprehensive literature search was performed in PubMed, including original studies and reviews, with no time limit on the studies included. The following search terms were used: antibody index, Goldmann–Witmer coefficient, Reibergram, viral encephalitis, viral uveitis, herpes simplex virus, varicella zoster virus, cytomegalovirus, Epstein–Barr virus, rubella virus, measles virus, enterovirus, influenza virus, flaviviruses. Content: Antibody indexes can support the diagnosis of a spectrum of viral infections in immune privileged sites such as the central nervous system and the eye, through the demonstration of virus-specific intrathecal or intraocular antibody production. This is especially useful in situations where PCR has a lower positivity rate: infections with rapid viral clearance due to natural immunity or treatment and chronic stages of viral infections. Implications: Antibody indexes expand the clinical microbiologist's diagnostic toolbox. Careful interpretation of the results of these assays is crucial and further standardization of methods is required to improve interchangeability of results between laboratories.
UR - http://www.scopus.com/inward/record.url?scp=85106347614&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2021.03.015
DO - 10.1016/j.cmi.2021.03.015
M3 - Review article
C2 - 33813108
AN - SCOPUS:85106347614
SN - 1198-743X
VL - 27
SP - 1207
EP - 1211
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 9
ER -
