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Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection.
Clin Infect Dis 2018; 66(8):1173-1180CI

Abstract

Background

To improve our understanding of the natural history of Zika virus (ZIKV) infection in humans, we described the dynamics of ZIKV RNA shedding in different body fluids and antibody responses in patients with acute infection.

Methods

Twenty-nine adults with travel-associated infection and 1 case of sexual transmission were enrolled and followed up with weekly ZIKV RNA testing in blood, urine, saliva, and semen samples and antibody testing.

Results

ZIKV RNA was detected in plasma, urine, and saliva of 57%, 93.1%, and 69.2% of participants, with estimated median times to clearance of 11.5 days (interquartile range [IQR] 6-24 days), 24 days (IQR, 17-34), and 14 days (IQR, 8-31), respectively. In 2 pregnant women, ZIKV RNA persisted in blood until delivery of apparently healthy infants. ZIKV RNA was detected in semen of 5 of 10 tested men; median time to clearance was 25 days (IQR 14-29), and the longest time of shedding in semen was 370 days. In flavivirus-naive patients, the median times to detection of ZIKV nonstructural protein 1 (NS1)-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were estimated as 8 days (IQR, 5-15 days) and 17 days (IQR, 12-26 days), respectively. ZIKV NS1 IgM antibodies were undetectable in patients with previous dengue.

Conclusions

Prolonged viremia and ZIKV RNA shedding in urine, saliva, and semen occur frequently in patients with acute ZIKV infection. At the time of diagnosis, about half of patients are ZIKV IgM negative. ZIKV NS1 IgM antibodies remain undetectable in patients with previous dengue. Estimates of the times to viral clearance and seroconversion are useful to optimize diagnostic algorithms.

Authors+Show Affiliations

Department of Molecular Medicine, University of Padova, Italy. Microbiology and Virology Unit, Padova University Hospital, Italy.Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.Microbiology and Virology Unit, Padova University Hospital, Italy.Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.Infectious Diseases Unit, Verona University Hospital, Italy.Infectious Diseases Unit, Padova University Hospital, Italy.Department of Molecular Medicine, University of Padova, Italy. Microbiology and Virology Unit, Padova University Hospital, Italy.Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29300893

Citation

Barzon, Luisa, et al. "Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 66, no. 8, 2018, pp. 1173-1180.
Barzon L, Percivalle E, Pacenti M, et al. Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection. Clin Infect Dis. 2018;66(8):1173-1180.
Barzon, L., Percivalle, E., Pacenti, M., Rovida, F., Zavattoni, M., Del Bravo, P., ... Baldanti, F. (2018). Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 66(8), pp. 1173-1180. doi:10.1093/cid/cix967.
Barzon L, et al. Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection. Clin Infect Dis. 2018 04 3;66(8):1173-1180. PubMed PMID: 29300893.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Virus and Antibody Dynamics in Travelers With Acute Zika Virus Infection. AU - Barzon,Luisa, AU - Percivalle,Elena, AU - Pacenti,Monia, AU - Rovida,Francesca, AU - Zavattoni,Maurizio, AU - Del Bravo,Paola, AU - Cattelan,Anna Maria, AU - Palù,Giorgio, AU - Baldanti,Fausto, PY - 2017/06/24/received PY - 2017/11/02/accepted PY - 2018/1/5/pubmed PY - 2018/1/5/medline PY - 2018/1/5/entrez SP - 1173 EP - 1180 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 66 IS - 8 N2 - Background: To improve our understanding of the natural history of Zika virus (ZIKV) infection in humans, we described the dynamics of ZIKV RNA shedding in different body fluids and antibody responses in patients with acute infection. Methods: Twenty-nine adults with travel-associated infection and 1 case of sexual transmission were enrolled and followed up with weekly ZIKV RNA testing in blood, urine, saliva, and semen samples and antibody testing. Results: ZIKV RNA was detected in plasma, urine, and saliva of 57%, 93.1%, and 69.2% of participants, with estimated median times to clearance of 11.5 days (interquartile range [IQR] 6-24 days), 24 days (IQR, 17-34), and 14 days (IQR, 8-31), respectively. In 2 pregnant women, ZIKV RNA persisted in blood until delivery of apparently healthy infants. ZIKV RNA was detected in semen of 5 of 10 tested men; median time to clearance was 25 days (IQR 14-29), and the longest time of shedding in semen was 370 days. In flavivirus-naive patients, the median times to detection of ZIKV nonstructural protein 1 (NS1)-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were estimated as 8 days (IQR, 5-15 days) and 17 days (IQR, 12-26 days), respectively. ZIKV NS1 IgM antibodies were undetectable in patients with previous dengue. Conclusions: Prolonged viremia and ZIKV RNA shedding in urine, saliva, and semen occur frequently in patients with acute ZIKV infection. At the time of diagnosis, about half of patients are ZIKV IgM negative. ZIKV NS1 IgM antibodies remain undetectable in patients with previous dengue. Estimates of the times to viral clearance and seroconversion are useful to optimize diagnostic algorithms. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29300893/Virus_and_Antibody_Dynamics_in_Travelers_With_Acute_Zika_Virus_Infection_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix967 DB - PRIME DP - Unbound Medicine ER -