Detection of Chikungunya Virus RNA in Oral Fluid and Urine: An Alternative Approach to Diagnosis?

• Published in: Viruses 2024-02, Vol.16 (2), p.235
• Main Authors: Jacob-Nascimento, Leile Camila, Portilho, Moyra M, Anjos, Rosângela O, Moreira, Patrícia S S, Stauber, Christine, Weaver, Scott C, Kitron, Uriel, Reis, Mitermayer G, Ribeiro, Guilherme S
• Format: Article
• Language: English
• Subjects: Analysis; Antibodies; Antibodies, Viral; chikungunya; Chikungunya Fever; Chikungunya virus; Chikungunya virus - genetics; Dengue - epidemiology; Dengue fever; Diagnosis; Disease Progression; Health aspects; Humans; Immunoglobulin M; Infections; Measurement; Medical laboratories; Methods; molecular diagnosis; oral fluid; Oral fluids; Patients; Performance evaluation; RNA; RNA viruses; RNA, Viral - genetics; RT-qPCR; Salivary diagnostics; Seroconversion; Serodiagnosis; Serology; Software; Surveillance; Urine; Vector-borne diseases
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v16020235

To evaluate whether oral fluids (OF) and urine can serve as alternative, non-invasive samples to diagnose chikungunya virus (CHIKV) infection via RT-qPCR, we employed the same RNA extraction and RT-qPCR protocols on paired serum, OF and urine samples collected from 51 patients with chikungunya during the acute phase of the illness. Chikungunya patients were confirmed through RT-qPCR in acute-phase sera (N = 19), IgM seroconversion between acute- and convalescent-phase sera (N = 12), or IgM detection in acute-phase sera (N = 20). The controls included paired serum, OF and urine samples from patients with non-arbovirus acute febrile illness (N = 28) and RT-PCR-confirmed dengue (N = 16). Nine (47%) of the patients with positive RT-qPCR for CHIKV in sera and two (17%) of those with CHIKV infection confirmed solely via IgM seroconversion had OF positive for CHIKV in RT-qPCR. One (5%) patient with CHIKV infection confirmed via serum RT-qPCR was positive in the RT-qPCR performed on urine. None of the negative control group samples were positive. Although OF may serve as an alternative sample for diagnosing acute chikungunya in specific settings, a negative result cannot rule out an infection. Further research is needed to investigate whether OF and urine collected later in the disease course when serum becomes RT-qPCR-negative may be helpful in CHIKV diagnosis and surveillance, as well as to determine whether urine and OF pose any risk of CHIKV transmission.