# Utility of VIDAS® Dengue Diagnostic Assays to Differentiate Primary and Secondary Dengue Infection: A Cross-Sectional Study in a Military Hospital from Colombia

## TL;DR

This study evaluates how well VIDAS® Dengue tests can distinguish between first and second dengue infections, helping diagnose and assess severity in patients.

## Contribution

The study demonstrates that parallel use of VIDAS® assays improves diagnostic accuracy and provides insights into immune responses in secondary dengue cases.

## Key findings

- Parallel testing with VIDAS® NS1, IgM, and IgG assays effectively differentiates primary and secondary dengue infections.
- NS1-negative cases showed higher IgM and IgG levels, suggesting a stronger immune response in secondary infections.
- Elevated IgG levels in secondary cases with warning signs correlate with increased risk for severe outcomes.

## Abstract

This study aimed to assess the diagnostic utility of VIDAS® DENGUE NS1 Ag and anti-DENV IgM and IgG assays in parallel for an early and accurate diagnosis and classification of dengue virus (DENV) infection. For this retrospective cross-sectional study, 190 patients with suspected dengue were tested using VIDAS® NS1, IgM, and IgG assays, requested in parallel, regardless of symptom onset timing, and classified into primary and secondary infections. Results were analyzed to determine diagnostic accuracy and correlation with disease severity. Parallel testing effectively differentiated between primary and secondary DENV infection. Secondary dengue cases with warning signs showed significantly elevated IgG levels (p = 0.026). Notably, NS1-negative (possible secondary cases) had higher IgM and IgG levels than NS1-positive cases (p < 0.01), suggesting that NS1 negativity might indicate an amplified immune response. In conclusion, VIDAS® Dengue diagnostic assays not only enhance the diagnostic accuracy of dengue infection but also offer valuable insights into serological patterns, especially in secondary cases. These assays could be used not only to confirm diagnosis but also to stratify patients by risk, particularly in cases of secondary dengue, where IgG levels might indicate a higher risk for severe outcomes.