Virus and Antibody Dynamics in Travelers with Acute Zika Virus Infection

Luisa Barzon, Elena Percivalle, Monia Pacenti, Francesca Rovida, Maurizio Zavattoni, Paola Del Bravo, Anna Maria Cattelan, Giorgio Palù, Fausto Baldanti

Research output: Contribution to journalArticle

19 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1173-1180
Number of pages8
JournalClinical Infectious Diseases
Volume66
Issue number8
DOIs
Publication statusPublished - Apr 3 2018

Fingerprint

Viruses
Antibodies
RNA
Semen
Immunoglobulin M
Saliva
Virus Shedding
Dengue
Urine
Zika Virus Infection
Zika Virus
Flavivirus
Proteins
Viremia
Body Fluids
Infection
Antibody Formation
Pregnant Women
Immunoglobulin G

Keywords

  • clearance
  • follow-up
  • persistence
  • semen
  • Zika virus

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Virus and Antibody Dynamics in Travelers with Acute Zika Virus Infection. / Barzon, Luisa; Percivalle, Elena; Pacenti, Monia; Rovida, Francesca; Zavattoni, Maurizio; Del Bravo, Paola; Cattelan, Anna Maria; Palù, Giorgio; Baldanti, Fausto.

In: Clinical Infectious Diseases, Vol. 66, No. 8, 03.04.2018, p. 1173-1180.

Research output: Contribution to journalArticle

Barzon, Luisa ; Percivalle, Elena ; Pacenti, Monia ; Rovida, Francesca ; Zavattoni, Maurizio ; Del Bravo, Paola ; Cattelan, Anna Maria ; Palù, Giorgio ; Baldanti, Fausto. / Virus and Antibody Dynamics in Travelers with Acute Zika Virus Infection. In: Clinical Infectious Diseases. 2018 ; Vol. 66, No. 8. pp. 1173-1180.
@article{3c97d6c1f5eb49859cccd92ffa5f2232,
title = "Virus and Antibody Dynamics in Travelers with Acute Zika Virus Infection",
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.",
keywords = "clearance, follow-up, persistence, semen, Zika virus",
author = "Luisa Barzon and Elena Percivalle and Monia Pacenti and Francesca Rovida and Maurizio Zavattoni and {Del Bravo}, Paola and Cattelan, {Anna Maria} and Giorgio Pal{\`u} and Fausto Baldanti",
year = "2018",
month = "4",
day = "3",
doi = "10.1093/cid/cix967",
language = "English",
volume = "66",
pages = "1173--1180",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "NLM (Medline)",
number = "8",

}

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 - 2018/4/3

Y1 - 2018/4/3

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.

AB - 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.

KW - clearance

KW - follow-up

KW - persistence

KW - semen

KW - Zika virus

UR - http://www.scopus.com/inward/record.url?scp=85045143051&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045143051&partnerID=8YFLogxK

U2 - 10.1093/cid/cix967

DO - 10.1093/cid/cix967

M3 - Article

VL - 66

SP - 1173

EP - 1180

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 8

ER -