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J Infect Dis. 2016 Oct 1;214(7):986-93. doi: 10.1093/infdis/jiw099. Epub 2016 Mar 16.

Homotypic Dengue Virus Reinfections in Nicaraguan Children.

Author information

1
Division of Infectious Diseases and Geographic Medicine, Department of Medicine.
2
National Virology Laboratory, Centro Nacional de Diagnóstico y Referencia.
3
Sustainable Sciences Institute, Managua, Nicaragua.
4
Department of Pathology, Stanford University School of Medicine.
5
Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley.
6
Centro de Salud Sócrates Flores Vivas, Ministry of Health.
7
Division of Infectious Diseases and Geographic Medicine, Department of Medicine Department of Pathology, Stanford University School of Medicine.

Abstract

BACKGROUND:

Infection with any of the 4 related dengue virus serotypes (DENV-1-4) is thought to result in lifelong immunity to homotypic reinfection (ie, reinfection with the same serotype).

METHODS:

Archived serum samples collected as part of an ongoing pediatric dengue cohort study in Nicaragua were tested for DENV by real-time reverse transcription polymerase chain reaction. Samples were collected from 2892 children who presented with an acute febrile illness clinically attributed to a non-DENV cause (hereafter, "C cases"). Test results were added to a database of previously identified symptomatic dengue cases in the cohort to identify repeat infections.

RESULTS:

Four patients with homotypic DENV reinfections were identified and confirmed among 29 repeat DENV infections (13.8%) with serotype confirmation. Homotypic reinfections with DENV-1, DENV-2, and DENV-3 occurred 325-621 days after the initial infection. Each patient experienced 1 symptomatic dengue case and 1 DENV-positive C case, and 2 patients presented with symptomatic dengue during their second infection. These DENV-positive C cases did not elicit long-lived humoral immune responses, despite viremia levels of up to 6.44 log10 copies per mL of serum.

CONCLUSIONS:

We describe the first set of virologically confirmed homotypic DENV reinfections. Such cases challenge the current understanding of DENV immunity and have important implications for modeling DENV transmission.

KEYWORDS:

dengue immunity; dengue virus; homotypic reinfection; repeat infection

PMID:
26984144
PMCID:
PMC5021223
DOI:
10.1093/infdis/jiw099
[Indexed for MEDLINE]
Free PMC Article

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