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Dingshinn Chen - One of the best experts on this subject based on the ideXlab platform.

  • higher cut off index value of IMMunoglobulin M Antibody to hepatitis b core antigen in taiwanese patients with hepatitis b
    Journal of Gastroenterology and Hepatology, 2006
    Co-Authors: Yiwen Huang, Peijer Chen, Jiahorng Kao, Ming Yang Lai, Chihlin Lin, Dingshinn Chen
    Abstract:

    Background:  The cut-off index value of IMMunoglobulin M (IgM) Antibody to hepatitis B core antigen (anti-HBc; AxSYM CORE-M, Abbott) for diagnosing acute hepatitis B is 1.2. A high false-positive rate of IgM anti-HBc was observed in acute flare-ups of chronic hepatitis B in Taiwanese patients. Thus the purpose of the present paper was to study the optiMal index value of IgM anti-HBc in Taiwanese subjects. Methods:  The peak index values of 42 IgM anti-HBc-positive patients were collected. There were 20 acute hepatitis B patients and 22 patients with chronic hepatitis B with acute flare. The biocheMical, virological, and serological data were obtained. Results:  There were significant differences in Mean age (36 vs 47 years, P = 0.01), seruM alanine aMinotransferase level (2042 U/L vs 1193 U/L, P = 0.02) and peak index value of IgM anti-HBc (2.9 vs 1.5, P  1.2. The optiMal cut-off index value to differentiate acute hepatitis B froM chronic hepatitis B with acute flare was 2.4–2.5, with a sensitivity of 90% and specificity of 90%. Conclusions:  The cut-off index value of IgM anti-HBc to differentiate acute hepatitis B froM chronic hepatitis B with acute flare aMong Taiwanese patients should be set at 2.4–2.5 instead of 0.8–1.2.

  • transient IMMunoglobulin M Antibody response to hepatitis c virus capsid antigen in posttransfusion hepatitis c putative serological Marker for acute viral infection
    Proceedings of the National Academy of Sciences of the United States of America, 1992
    Co-Authors: Peijer Chen, Jintown Wang, Lih Hwa Hwang, Yann Hwa Yang, Chia Ling Hsieh, Jiahorng Kao, Jinchuan Sheu, Ming Yang Lai, Teh Hong Wang, Dingshinn Chen
    Abstract:

    Abstract The developMent of serological assays for hepatitis C virus (HCV) has Made specific diagnosis possible. However, Markers useful in indicating acute-phase HCV infection have not been identified. By an iMMunoblotting Method, we characterized the IgM and IgG Antibody response against HCV capsid antigen in patients with HCV infection. AMong 88% of patients with acute posttransfusion hepatitis C recruited in a prospective study, there was a transient IgM Antibody response. The IgM Antibody appeared shortly after onset of hepatitis (average 3.7 weeks), persisted for several Months (average 18 weeks), and then disappeared. In contrast, the IgG Antibody persisted long-terM once it appeared. AMong patients with chronic hepatitis C with Milder disease activities (seruM aMinotransferase increase above norMal levels of less than 4-fold), the IgM Antibody was negative in the Majority (72%). In those with acute exacerbations (aMinotransferase increase of greater than 10-fold), about 55% were negative for the IgM Antibody. The reactivity of the IgM Antibody in the rest was weaker or becaMe negative upon further dilution of seruM. The results suggest that IgM anti-capsid Antibody May serve as a Marker indicating acute or active HCV infection.

John T Roehrig - One of the best experts on this subject based on the ideXlab platform.

  • developMent of a huMan Murine chiMeric IMMunoglobulin M Antibody for use in the serological detection of huMan flavivirus antibodies
    Clinical and Vaccine Immunology, 2009
    Co-Authors: Brett A Thibodeaux, John T Roehrig
    Abstract:

    Current diagnosis of huMan flaviviral infections relies heavily on serological techniques such as the IMMunoglobulin M (IgM) Antibody capture enzyMe-linked iMMunosorbent assay (MAC-ELISA). Broad application of this assay is hindered by a lack of standardized huMan positive-control sera that react with the wide variety of flaviviruses that can cause huMan disease, e.g., dengue virus (DENV), West Nile virus (WNV), yellow fever virus (YFV), Japanese encephalitis virus (JEV), and St. Louis encephalitis virus (SLEV). We have created a huMan-Murine chiMeric Antibody coMbining the variable regions of the broadly flavivirus cross-reactive Murine Monoclonal Antibody (MAb) 6B6C-1 and the constant region of huMan IgM to produce a standardized reagent capable of replacing huMan positive-control sera in a MAC-ELISA for the diagnosis of all huMan flaviviral infections. The huMan-Murine chiMeric IgM Antibody secreted froM plasMid-transforMed Sp2/0Ag14 cells had a level of serological activity identical to that of 6B6C-1 as Measured by ELISA, iMMunoblotting, and MAC-ELISA for Multiple MeMbers of the flavivirus genus, including WNV, SLEV, YFV, DENV, and JEV.

  • persistence of virus reactive seruM IMMunoglobulin M Antibody in confirMed west nile virus encephalitis cases
    Emerging Infectious Diseases, 2003
    Co-Authors: John T Roehrig, Denise A Martin, Denis Nash, Beth Maldin, Anne Labowitz, Robert S Lanciotti, Grant L Campbell
    Abstract:

    Twenty-nine laboratory-confirMed West Nile virus (WNV) encephalitis patients were bled serially so that WNV-reactive IMMunoglobulin (Ig) M activity could be deterMined. Of those patients bled, 7 (60%) of 12 had anti-WNV IgM at approxiMately 500 days after onset. Clinicians should be cautious when interpreting serologic results froM early season WNV IgM-positive patients.

  • standardization of IMMunoglobulin M capture enzyMe linked iMMunosorbent assays for routine diagnosis of arboviral infections
    Journal of Clinical Microbiology, 2000
    Co-Authors: Denise A Martin, David A Muth, Teresa M Brown, Alison J Johnson, Nick Karabatsos, John T Roehrig
    Abstract:

    IMMunoglobulin M Antibody-capture enzyMe-linked iMMunosorbent assay (MAC-ELISA) is a rapid and versatile diagnostic Method that readily perMits the coMbination of Multiple assays. Test consolidation is especially iMportant for arthropod-borne viruses (arboviruses) which belong to at least three virus faMilies: the Togaviridae, Flaviviridae, and Bunyaviridae. Using prototype viruses froM each of these faMilies and a panel of well-characterized huMan sera, we have evaluated and standardized a coMbined MAC-ELISA capable of identifying virus infections caused by MeMbers of each virus faMily. FurtherMore, by grouping antigens geographically and utilizing known serological cross-reactivities, we have reduced the nuMber of antigens necessary for testing, while Maintaining adequate detection sensitivity. We have deterMined that a 1:400 seruM dilution is Most appropriate for screening antiviral Antibody, using a positive-to-negative ratio of ≥2.0 as a positive cutoff value. With a blind-coded huMan seruM panel, this coMbined MAC-ELISA was shown to have test sensitivity and specificity that correlated well with those of other serological techniques.

Jack S Remington - One of the best experts on this subject based on the ideXlab platform.

  • confirMatory serologic testing for acute toxoplasMosis and rate of induced abortions aMong woMen reported to have positive toxoplasMa IMMunoglobulin M Antibody titers
    American Journal of Obstetrics and Gynecology, 2001
    Co-Authors: Oliver Liesenfeld, Jose G Montoya, Naga J Tathineni, Meg Davis, Byron W Brown, Kristin Cobb, Julie Parsonnet, Jack S Remington
    Abstract:

    OBJECTIVE: Results obtained with coMMercial testing kits for IMMunoglobulin M ToxoplasMa antibodies May be inaccurate or May be inaccurately interpreted, which May influence whether a woMan decides to terMinate the pregnancy. This study was undertaken to deterMine whether confirMatory testing at a reference laboratory and coMMunication of the results and an expert interpretation to the patient's physician would affect the rate of induced abortions aMong pregnant woMen with positive results of testing for IMMunoglobulin M ToxoplasMa antibodies in outside laboratories. STUDY DESIGN: This was a retrospective cohort study of 811 consecutive pregnant woMen for whoM the toxoplasMa serologic profile was perforMed at a reference laboratory. AlMost all the patients had been inforMed by their physicians that a result of a test for IMMunoglobulin M ToxoplasMa antibodies perforMed in an outside laboratory was positive. WoMen were separated into those with a toxoplasMa serologic profile result suggestive of a recently acquired infection (group 1) and those with a result suggestive of an infection acquired in the More distant past (group 2). Physician reports of induced abortions were used to deterMine rates of induced abortion in groups 1 and 2. RESULTS: Of the 811 woMen 321 (39.6%) were considered likely to have a recent infection (group 1) and 490 (60.4%) were considered likely to have a past infection (group 2). Physicians reported pregnancy outcoMes for 433 (53.4%) of 811 woMen (65.1% and 45.7% in groups 1 and 2, respectively). Whereas 36 of 209 woMen in group 1 (17.2%) terMinated the pregnancy, only 1 of 224 woMen in group 2 (0.4%) chose abortion (P <.001). CONCLUSION: ConfirMatory serologic testing in a reference laboratory and coMMunication of the results and their correct interpretation by an expert to the patient's physician decreased the rate of unnecessary abortions by approxiMately 50% aMong woMen for whoM positive IMMunoglobulin M ToxoplasMa test results had been reported by outside laboratories.

  • confirMatory serologic testing for acute toxoplasMosis and rate of induced abortions aMong woMen reported to have positive toxoplasMa IMMunoglobulin M Antibody titers
    American Journal of Obstetrics and Gynecology, 2001
    Co-Authors: Oliver Liesenfeld, Jose G Montoya, Naga J Tathineni, Meg Davis, Byron W Brown, Kristin Cobb, Julie Parsonnet, Jack S Remington
    Abstract:

    Abstract Objective: Results obtained with coMMercial testing kits for IMMunoglobulin M ToxoplasMa antibodies May be inaccurate or May be inaccurately interpreted, which May influence whether a woMan decides to terMinate the pregnancy. This study was undertaken to deterMine whether confirMatory testing at a reference laboratory and coMMunication of the results and an expert interpretation to the patient's physician would affect the rate of induced abortions aMong pregnant woMen with positive results of testing for IMMunoglobulin M ToxoplasMa antibodies in outside laboratories. Study Design: This was a retrospective cohort study of 811 consecutive pregnant woMen for whoM the toxoplasMa serologic profile was perforMed at a reference laboratory. AlMost all the patients had been inforMed by their physicians that a result of a test for IMMunoglobulin M ToxoplasMa antibodies perforMed in an outside laboratory was positive. WoMen were separated into those with a toxoplasMa serologic profile result suggestive of a recently acquired infection (group 1) and those with a result suggestive of an infection acquired in the More distant past (group 2). Physician reports of induced abortions were used to deterMine rates of induced abortion in groups 1 and 2. Results: Of the 811 woMen 321 (39.6%) were considered likely to have a recent infection (group 1) and 490 (60.4%) were considered likely to have a past infection (group 2). Physicians reported pregnancy outcoMes for 433 (53.4%) of 811 woMen (65.1% and 45.7% in groups 1 and 2, respectively). Whereas 36 of 209 woMen in group 1 (17.2%) terMinated the pregnancy, only 1 of 224 woMen in group 2 (0.4%) chose abortion ( P Conclusion: ConfirMatory serologic testing in a reference laboratory and coMMunication of the results and their correct interpretation by an expert to the patient's physician decreased the rate of unnecessary abortions by approxiMately 50% aMong woMen for whoM positive IMMunoglobulin M ToxoplasMa test results had been reported by outside laboratories. (AM J Obstet Gynecol 2001;184:140-5.)

Terry Schmidt - One of the best experts on this subject based on the ideXlab platform.

Jennifer A Cuthbert - One of the best experts on this subject based on the ideXlab platform.

  • Multiple factors contribute to positive results for hepatitis a virus IMMunoglobulin M Antibody
    Archives of Pathology & Laboratory Medicine, 2013
    Co-Authors: Adnan Alatoom, Qasim M Ansari, Jennifer A Cuthbert
    Abstract:

    CONTEXT: In the United States, a successful vaccination prograM for hepatitis A virus (HAV) infection has decreased both its incidence and the true positive rate for diagnostic IMMunoglobulin M (IgM) Antibody to HAV in acute hepatitis. OBJECTIVE: To survey positive results of HAV IgM tests and deterMine the effect of changing ordering options. DESIGN: We reviewed all positive results for IgM Antibody to HAV between January 2007 and DeceMber 2010. Patient deMographics, clinical history, and laboratory data were recorded and the encounter, order, and reason for test reviewed. Each result was categorized as indicating acute, recent, resolved, or indeterMinate HAV infection. RESULTS: A total of 10,735 tests were perforMed; 35 patients had 49 positive results. Most positive test results were associated with outpatient visits and were ordered in the assessMent of patients with liver disease, but not clinical acute hepatitis. In the final analysis, 4 patients had acute hepatitis A and 20 individual patients had recent and/or resolved hepatitis. All but 1 of the reMaining 11 patients had another established cause of liver disease with a positive IgM HAV Antibody test result; data to deterMine causality were insufficient. The total nuMber of tests requested annually decreased More than 35% with the introduction of coMputerized physician order entry. CONCLUSIONS: Current assays for IgM HAV antibodies are overused in the absence of clinical acute hepatitis; future clinical decision support May iMprove patterns of order entry. Most patients have findings consistent with HAV exposure but not acute hepatitis; dorMant viral infection May be a continuing source of antigen.

  • Multiple factors contribute to positive results for hepatitis a virus IMMunoglobulin M Antibody
    Archives of Pathology & Laboratory Medicine, 2013
    Co-Authors: Adnan Alatoom, Qasim M Ansari, Jennifer A Cuthbert
    Abstract:

    Context.—In the United States, a successful vaccination prograM for hepatitis A virus (HAV) infection has decreased both its incidence and the true positive rate for diagnostic IMMunoglobulin M (Ig...