CDC DENV-1-4 rRT-PCR Multiplex and Trioplex rRT-PCR Assays
What are these assays?
- The CDC DENV-1-4 rRT-PCR multiplex assay is a laboratory test designed to detect and serotype dengue virus infections. If positive, the result indicates the infecting dengue virus serotype. The Food and Drug Administration (FDA) cleared this test in 2013.
- The CDC Trioplex rRT-PCR assay can diagnose dengue infections (as well as chikungunya infections) while Zika infection is being ruled out. FDA has authorized the use of this test under an Emergency Use Authorization (EUA) [PDF – 59 pages] for suspect Zika cases.
How should these assays be used and at what time during infection?
- Use the CDC DENV-1-4 rRT-PCR multiplex assay when the primary suspicion is a dengue infection and distinguishing the four dengue virus serotypes is desired.
- Use the CDC Trioplex rRT-PCR assay in areas where dengue, chikungunya, and Zika are likely co-circulating.
- As above, testing should be done for specimens from the first 7 days of illness.
- Whole blood (CDC Trioplex rRT-PCR assay)
- Cerebrospinal fluid (CDC Trioplex rRT-PCR assay)
Interpretation of results
A positive test result for each dengue virus serotype in the CDC DENV-1-4 rRT-PCR multiplex assay or for dengue in the CDC Trioplex rRT-PCR assay confirms dengue infection, however, a negative test result does not preclude infection. Serologic results should also be taken into account for complete assessment of the case.
When using the CDC Trioplex rRT-PCR assay, the results for chikungunya and Zika, and serological results should be considered for complete assessment of the case.
Many public health laboratories offer molecular testing for dengue and Zika. The CDC provides public health laboratories with CDC DENV-1-4 rRT-PCR multiplex assay kits and CDC Trioplex rRT-PCR assay kits. Commercial laboratories run their own to Clinical Laboratory Improvement Amendments (CLIA)-approved dengue NATs.