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Dengue Plaque Reduction Neutralization Test (PRNT) in Primary and Secondary Dengue Virus Infections: How Alterations in Assay Conditions Impact Performance

Stephen J. Thomas Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Ananda Nisalak Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Kathryn B. Anderson Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Daniel H. Libraty Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Siripen Kalayanarooj Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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David W. Vaughn Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Robert Putnak Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Robert V. Gibbons Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Richard Jarman Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Timothy P. Endy Department of Virology, United States Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia; Center for Infectious Disease and Vaccine Research, University of Massachusetts Medical School, Worcester, Massachusetts; Queen Sirikit National Institute of Child Health, Rajvithi Road, Bangkok, Thailand; Infectious Disease Division, Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York

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Dengue virus (DENV) infection is a worsening global health problem. The plaque reduction neutralization test (PRNT) is currently considered to be the “gold standard” to characterize and quantify circulating levels of anti-DENV neutralizing antibody (NAb). Many variations of the PRNT are currently in use and neither the assay nor its performance conditions have been standardized or harmonized between laboratories. We used a well-characterized panel of acute and late convalescent follow-up sera samples from children experiencing primary and secondary DENV infections to evaluate the performance of the dengue PRNT under a variety of testing conditions. Investigators varied cell type, control virus passage, and the use of complement across multiple assay runs of the same sample panel. Our findings indicate wide variation in PRNT titer results in response to varied testing conditions.

Author Notes

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