Application Value of the Point-of-Care Nucleic Acid Test and Antigen Detection in the Detection of Influenza A/B Virus In-fection
LIANG Yuying
ZHANG Naijian
HU Yuhai
TIAN Peifu
Abstract：Objective To evaluate the application value of the point-of-care nucleic acid test and antigen detection in the detection of clinical influenza A/B virus(FluA/FluB)infection,and to objectively evaluate the consistency of positive classifica-tion reports of antigen test results.Methods A total of 122 patients with upper respiratory tract infection at the author's hospital from March to December 2023 were randomly selected,oropharyngeal swabs were collected from these patients,and real-time fluorescent reverse transcription polymerase chain reaction(RT-PCR),point-of-care nucleic acid test and colloidal gold immuno-chromatography(GICA)were respectively performed on FluA/FluB nucleic acid and antigen detection.The RT-PCR results were used as the"gold standard"to evaluate the performance of point-of-care nucleic acid test and GICA.For the samples with inconsistent results,the second RT-PCR assay was used to further verify the results.At the same time,according to the relative load namely cycle threshold(Ct)of RT-PCR FluA detection,the consistency of three levels of reporting methods of strong positive,positive and weak positive antigen detection was evaluated.Results Statistical analysis revealed that the sen-sitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of point-of-care nucleic acid test for FluA detection were 100.00％[95％confidence interval(CI):92.73％-100.00％],95.00％(95％CI:85.18％-98.70％),95.38％(95％CI:86.24％-98.80％)and 100.00％(95％CI:92.13％-100.00％),respectively;for FluB,the corresponding performance metrics were 100.00％(95％CI:73.24％-100.00％),98.15％(95％CI:92.81％-99.68％),87.50％(95％CI:60.41％-97.80％)and 100.00％(95％CI:95.65％-100.00％).Statistical analysis demonstrated that the FluA/FluB results of point-of-care nucleic acid test exhibited a high degree of consistency with detection results of RT-PCR(K=0.951 and 0.924 respectively),and both methods revealed significantly positive correlation(r=0.754 and 0.678 respectively,P＜0.05).The sensitivity,specificity,PPV and NPV of GICA antigen de-tection for FluA were 92.73％(95％CI:81.57％-97.64％),79.10％(95％CI:67.11％-87.71％),78.46％(95％CI:66.19％-87.32％)and 92.98％(95％CI:82.17％-97.73％),respectively;the corresponding indexes of FluB were 82.35％(95％CI:55.80％-95.33％),98.10％(95％CI:92.62％-99.67％),87.50％(95％CI:60.41％-97.80％)and 97.17％(95％CI:91.35％-99.27％),respectively.Compared with RT-PCR,GICA antigen detection showed moderate consistency in FluA(K=0.707)and high consistency in FluB(K=0.825).Notably,statistical analy-sis of the three-level antigen test reports indicated that the Ct value of FluA in the strong positive group＜Ct value in positive group,Ct value in the strong positive group＜Ct value in the weak positive group(all P＜0.05),but there was no significant difference between the positive group and the weak positive group(P＞0.05).Conclusion The results of point-of-care nucleic acid test and RT-PCR FluA/FluB detection are highly consistent and positively correlated,and the sensitivity,specificity,PPV and NPV of point-of-care nucleic acid detection are higher than GICA antigen detection,which has good application value and prospect in rapid detection of influenza-like illness in outpatient and emergency de-partment.At the same time,it is recommended that the FluA antigen test should be used in the form of strong positive and positive secondary report to ensure the accuracy of the test report.
Keywords：Upper respiratory tract infectionInfluenza A virusInfluenza B virusPoint-of-care nucleic acid testReal-time fluorescent reverse transcription polymerase chain reactionColloidal gold immunochromatography
Publication Date：2025-08-28
Online Publishing Date：2025-09-18(First online date of this platform, not the publication date of the document)
Pages：5( 694-698 )