Lab Med Qual Assur 2022; 44(1): 40-47
Published online March 31, 2022
Copyright © Korean Association of External Quality Assessment Service.
1Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin; 2Department of Laboratory Medicine, Hwahong Hospital, Myeongin Medical Foundation, Suwon, Korea
Correspondence to:Mi-Soon Han
Department of Laboratory Medicine, Hwahong Hospital, Myeongin Medical Foundation, 98 Homaesil-ro 90beon-gil, Gwonseon-gu, Suwon 16630, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Current infections are frequently diagnosed based on positive immunoglobulin (Ig) M results, although false positivity can occur. We evaluated cross-reactivity among infectious antibody (Ab) assays.
Methods: A total of 167 positive sera were collected for: rubella IgM and IgG, cytomegalovirus (CMV) IgM and IgG, Toxoplasma gondii (Toxo) IgG, human immunodeficiency virus (HIV) antigen (Ag)/Ab, hepatitis A virus (HAV) IgM and IgG, hepatitis C virus (HCV) Ab, herpes simplex virus (HSV) IgM and IgG, Epstein-Barr virus viral capsid Ag IgM, hepatitis B core (HBc) IgM, hepatitis B e Ab, and severe acute respiratory syndrome coronavirus 2 total Ab, Treponema pallidum IgM (each n=10) and Toxo IgM (n=7). All sera were tested with seven assays in duplicate: Architect rubella IgM, CMV IgM, Toxo IgM, HIV Ag/Ab, HAV IgM, anti-HCV (Abbott Laboratories, USA), and Elecsys HBc IgM (Roche Diagnostics GmbH, Germany). Additionally, sera showing repeatedly reactive were evaluated by following supplemental testing: Elecsys Toxo IgM, HIV Duo and HAV IgM, VIDAS rubella IgM and CMV IgM (bioMérieux SA, France); LIAISON XL CMV IgM (DiaSorin S.p.A., Italy); and HCV blot 3.0 (MP Diagnostics Inc., Philippines).
Results: Except Elecsys HBc IgM, six assays showed reactive for several sera, including other infectious Abs. Upon supplemental testing, Architect rubella IgM, CMV IgM, and anti-HCV showed reactive or gray zone for two sera with HSV IgM (κ=0.903), eight to fifteen with various Abs (κ=0.607–0.814), and one with HAV IgG (κ=0.960), respectively.
Conclusions: Architect rubella IgM, CMV IgM, and anti-HCV showed cross-reactivity with reactive sera to other infectious Abs. Considering cross-reactivity of Ab assays with other pre-existing infectious Abs, infectious Ab results should be carefully interpreted.
Keywords: Immunoassay, Viral antibodies, Immunoglobulin M, Immunoglobulin G, Cross-reactivity
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