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da Silva JBC, Carvalho FR, Paiva IA, Familiar-Macedo D, Dias HG, Pauvolid-Corrêa A, Fernandes-Santos C, Lima MDRQ, Gandini M, Silva AA, Cavalcanti SMB, de Oliveira SA, Vianna RADO, de Azeredo EL, Cardoso CAA, Grifoni A, Sette A, Weiskopf D, de-Oliveira-Pinto LM. DIFERENÇA NA LONGEVIDADE DE LINFÓCITOS T CD4+ E CD8+ EM UMA COORTE DE MÃES E CRIANÇAS COM HISTÓRICO DE INFECÇÃO POR ZIKV. Braz J Infect Dis 2022. [DOI: 10.1016/j.bjid.2021.102271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lima MDRQ, de Lima RC, de Azeredo EL, dos Santos FB. Analysis of a Routinely Used Commercial Anti-Chikungunya IgM ELISA Reveals Cross-Reactivities with Dengue in Brazil: A New Challenge for Differential Diagnosis? Diagnostics (Basel) 2021; 11:diagnostics11050819. [PMID: 33946597 PMCID: PMC8147240 DOI: 10.3390/diagnostics11050819] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/23/2021] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
In Brazil, chikungunya emerged in 2014, and by 2016, co-circulated with other arbovirosis, such as dengue and zika. ELISAs (Enzyme-Linked Immunosorbent Assays) are the most widely used approach for arboviruses diagnosis. However, some limitations include antibody cross reactivities when viruses belong to the same genus, and sensitivity variations in distinct epidemiological scenarios. As chikungunya virus (CHIKV) is an alphavirus, no serological cross reactivity with dengue virus (DENV) should be observed. Here, we evaluated a routinely used chikungunya commercial IgM (Immunoglobulin M) ELISA test (Anti-Chikungunya IgM ELISA, Euroimmun) to assess its performance in confirming chikungunya in a dengue endemic area. Samples (n = 340) representative of all four DENV serotypes, healthy individuals and controls were tested. The Anti-CHIKV IgM ELISA test had a sensitivity of 100% and a specificity of 25.3% due to the cross reactivities observed with dengue. In dengue acute cases, the chikungunya test showed an overall cross-reactivity of 31.6%, with a higher cross-reactivity with DENV-4. In dengue IgM positive cases, the assay showed a cross-reactivity of 46.7%. Serological diagnosis may be challenging and, despite the results observed here, more evaluations shall be performed. Because distinct arboviruses co-circulate in Brazil, reliable diagnostic tools are essential for disease surveillance and patient management.
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Badolato-Corrêa J, Carvalho FR, Paiva IA, Familiar-Macedo D, Dias HG, Pauvolid-Corrêa A, Fernandes-Santos C, Lima MDRQ, Gandini M, Silva AA, Baeta Cavalcanti SM, de Oliveira SA, de Oliveira Vianna RA, de Azeredo EL, Cardoso CAA, Grifoni A, Sette A, Weiskopf D, de-Oliveira-Pinto LM. Differential Longevity of Memory CD4 and CD8 T Cells in a Cohort of the Mothers With a History of ZIKV Infection and Their Children. Front Immunol 2021; 12:610456. [PMID: 33679748 PMCID: PMC7928292 DOI: 10.3389/fimmu.2021.610456] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/22/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Zika virus (ZIKV) infection causes for mild and self-limiting disease in healthy adults. In newborns, it can occasionally lead to a spectrum of malformations, the congenital Zika syndrome (CZS). Thus, little is known if mothers and babies with a history of ZIKV infection were able to develop long-lasting T-cell immunity. To these issues, we measure the prevalence of ZIKV T-cell immunity in a cohort of mothers infected to the ZIKV during pregnancy in the 2016–2017 Zika outbreak, who gave birth to infants affected by neurological complications or asymptomatic ones. Results: Twenty-one mothers and 18 children were tested for IFN-γ ELISpot and T-cell responses for flow cytometry assays in response to CD4 ZIKV and CD8 ZIKV megapools (CD4 ZIKV MP and CD8 ZIKV MP). IFN-γ ELISpot responses to ZIKV MPs showed an increased CD4 and CD8 T-cell responses in mothers compared to children. The degranulation activity and IFN-γ-producing CD4 T cells were detected in most mothers, and children, while in CD8 T-cells, low responses were detected in these study groups. The total Temra T cell subset is enriched for IFN-γ+ CD4 T cells after stimulation of CD4 ZIKV MP. Conclusion: Donors with a history of ZIKV infection demonstrated long-term CD4 T cell immunity to ZIKV CD4 MP. However, the same was not observed in CD8 T cells with the ZIKV CD8 MP. One possibility is that the cytotoxic and pro-inflammatory activities of CD8 T cells are markedly demonstrated in the early stages of infection, but less detected in the disease resolution phase, when the virus has already been eliminated. The responses of mothers' T cells to ZIKV MPs do not appear to be related to their children's clinical outcome. There was also no marked difference in the T cell responses to ZIKV MP between children affected or not with CZS. These data still need to be investigated, including the evaluation of the response of CD8 T cells to other ZIKV peptides.
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Affiliation(s)
| | - Fabiana Rabe Carvalho
- Multiuser Laboratory for Research in Nephrology and Medical Science, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | - Iury Amancio Paiva
- Laboratory of Viral Immunology, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | - Alex Pauvolid-Corrêa
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX, United States.,Laboratory of Respiratory Viruses and Measles, Fiocruz, Rio de Janeiro, Brazil
| | | | | | - Mariana Gandini
- Laboratory of Cellular Microbiology, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Andréa Alice Silva
- Multiuser Laboratory for Research in Nephrology and Medical Science, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | | | | | - Claudete Aparecida Araújo Cardoso
- Multiuser Laboratory for Research in Nephrology and Medical Science, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil.,Department of Maternal and Child, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | - Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), San Diego, CA, United States
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), San Diego, CA, United States.,Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, San Diego, CA, United States
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), San Diego, CA, United States
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Sánchez-Arcila JC, Badolato-Correa J, de Souza TMA, Paiva IA, Barbosa LS, Nunes PCG, Lima MDRQ, Dos Santos FB, Damasco PV, da Cunha RV, Azeredo ELD, de Oliveira-Pinto LM. Clinical, Virological, and Immunological Profiles of DENV, ZIKV, and/or CHIKV-Infected Brazilian Patients. Intervirology 2020; 63:33-45. [PMID: 32966990 DOI: 10.1159/000510223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 06/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Arboviruses co-circulating within a population that are transmitted by the same vector have the potential to cause coinfections. Coinfections with dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) have been occurring in Brazil, but it is not well-understood how human responses vary during mono- or coinfections and whether they play different roles in pathogenesis. METHODS We investigated the clinical, virological, and immunological status during patients' acute infections, focusing on the CCL/CXC chemokines, proinflammatory, as well as anti-inflammatory cytokines levels quantified by ELISAs. Viral load was determined by qRT-PCR in serum samples from 116 acute DENV, ZIKV, CHIKV, DENV/ZIKV, and CHIKV/ZIKV-infected adult patients from Brazil. RESULTS Most of the acute patients displayed fever, headache, prostration, and myalgia, regardless of the type of arbovirus infection. Zika viral load was higher in CHIKV/ZIKV coinfected patients compared with ZIKV or DENV/ZIKV infections. All infected individuals presented increased concentrations of C-X-C motif chemokine ligand 10/interferon protein-10 (CXCL10/IP-10), C-C motif chemokine ligand 2/monocyte chemoattractant protein-1 (CCL2/MCP-1), and tumor necrosis factor alpha (TNF-α) compared to healthy donors. Interestingly, the ZIKV group separated from CHIKV/ZIKV due to higher levels of interleukin-10 (IL-10) and lower levels of TNF-α. While DENV/ZIKV differentiated from CHIKV due to their higher levels of CCL2/MCP-1, in CHIKV- and CHIKV/ZIKV-infected patients, levels of CXC10/IP-10, CCL2/MCP-1, and migration inhibitory factor (MIF) were associated with CHIKV viral load. By contrast, in DENV/ZIKV- and CHIKV/ZIKV-infected patients, levels of CXCL10/IP-10, CCL2/MCP-1, and TNF-α showed a significant inverse correlation with ZIKV viral load. CONCLUSIONS From all the circulating mediators measured, we detected differences of IL-10, TNF-α, and CCL2/MCP-1 between arbovirus groups. We hypothesize that CXC10/IP-10, CCL2/MCP-1, and MIF in the CHIKV-infected group could regulate the CHIKV viral load, while CXC10/IP-10, CCL2/MCP-1, and TNF-α in DENV/ZIKV, and CHIKV/ZIKV groups, could regulate ZIKV viral load.
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Affiliation(s)
- Juan Camilo Sánchez-Arcila
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Jessica Badolato-Correa
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | | | - Iury Amâncio Paiva
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Luciana Santos Barbosa
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil.,Laboratory of Genetics, Institute of Paediatrics and Puericulture Martagão Gesteira (IPPMG), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Flavia Barrento Dos Santos
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Paulo Vieira Damasco
- Universitary Hospital Gaffrée Guinle, Federal University of State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Rivaldo Venancio da Cunha
- Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo Grande (UFMG), Campo Grande, Brazil
| | - Elzinandes Leal de Azeredo
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil,
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de Abreu FVS, Ferreira-de-Brito A, Azevedo ADS, Linhares JHR, de Oliveira Santos V, Hime Miranda E, Neves MSAS, Yousfi L, Ribeiro IP, dos Santos AAC, dos Santos E, dos Santos TP, Teixeira DS, Gomes MQ, Fernandes CB, da Silva AMV, Lima MDRQ, Paupy C, Romano APM, Ano Bom APD, de Oliveira-Pinto LM, Moutailler S, Motta MDA, Castro MG, Bonaldo MC, Maria Barbosa de Lima S, Lourenço-de-Oliveira R. Survey on Non-Human Primates and Mosquitoes Does not Provide Evidences of Spillover/Spillback between the Urban and Sylvatic Cycles of Yellow Fever and Zika Viruses Following Severe Outbreaks in Southeast Brazil. Viruses 2020; 12:E364. [PMID: 32224891 PMCID: PMC7232473 DOI: 10.3390/v12040364] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/10/2020] [Accepted: 02/16/2020] [Indexed: 12/14/2022] Open
Abstract
In the last decade, Flaviviruses such as yellow fever (YFV) and Zika (ZIKV) have expanded their transmission areas. These viruses originated in Africa, where they exhibit both sylvatic and interhuman transmission cycles. In Brazil, the risk of YFV urbanization has grown, with the sylvatic transmission approaching the most densely populated metropolis, while concern about ZIKV spillback to a sylvatic cycle has risen. To investigate these health threats, we carried out extensive collections and arbovirus screening of 144 free-living, non-human primates (NHPs) and 5219 mosquitoes before, during, and after ZIKV and YFV outbreaks (2015-2018) in southeast Brazil. ZIKV infection was not detected in any NHP collected at any time. In contrast, current and previous YFV infections were detected in NHPs sampled between 2017 and 2018, but not before the onset of the YFV outbreak. Mosquito pools screened by high-throughput PCR were positive for YFV when captured in the wild and during the YFV outbreak, but were negative for 94 other arboviruses, including ZIKV, regardless of the time of collection. In conclusion, there was no evidence of YFV transmission in coastal southeast Brazil before the current outbreak, nor the spread or establishment of an independent sylvatic cycle of ZIKV or urban Aedes aegypti transmission of YFV in the region. In view of the region's receptivity and vulnerability to arbovirus transmission, surveillance of NHPs and mosquitoes should be strengthened and continuous.
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Affiliation(s)
- Filipe Vieira Santos de Abreu
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
- Instituto Federal do Norte de Minas Gerais, Salinas 39560-000, Brazil
| | - Anielly Ferreira-de-Brito
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
| | - Adriana de Souza Azevedo
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (A.d.S.A.); (J.H.R.L.); (V.d.O.S.); (E.H.M.); (S.M.B.d.L.)
| | - José Henrique Rezende Linhares
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (A.d.S.A.); (J.H.R.L.); (V.d.O.S.); (E.H.M.); (S.M.B.d.L.)
| | - Vanessa de Oliveira Santos
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (A.d.S.A.); (J.H.R.L.); (V.d.O.S.); (E.H.M.); (S.M.B.d.L.)
| | - Emily Hime Miranda
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (A.d.S.A.); (J.H.R.L.); (V.d.O.S.); (E.H.M.); (S.M.B.d.L.)
| | - Maycon Sebastião Alberto Santos Neves
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
| | - Lena Yousfi
- UMR BIPAR, Animal Health Laboratory, ANSES, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France; (L.Y.); (S.M.)
| | - Ieda Pereira Ribeiro
- Laboratório de Biologia Molecular de Flavivirus, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (I.P.R.); (A.A.C.d.S.); (M.C.B.)
| | - Alexandre Araújo Cunha dos Santos
- Laboratório de Biologia Molecular de Flavivirus, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (I.P.R.); (A.A.C.d.S.); (M.C.B.)
| | - Edmilson dos Santos
- Divisão de Vigilância Ambiental em Saúde, Secretaria de Saúde do Rio Grande do Sul, Porto Alegre 90610-000, Brazil;
| | - Taissa Pereira dos Santos
- MIVEGEC, CNRS, Institut de Recherche pour le Développement (IRD), Université de Montpellier, 34394 Montpellier, France; (T.P.d.S.); (C.P.)
| | - Danilo Simonini Teixeira
- Núcleo de Atendimento e Pesquisa de Animais Silvestres, Universidade Estadual de Santa Cruz, Ilhéus 45662-900, Brazil;
| | - Marcelo Quintela Gomes
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
| | - Camilla Bayma Fernandes
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (C.B.F.); (A.M.V.d.S.); (A.P.D.A.B.)
| | - Andrea Marques Vieira da Silva
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (C.B.F.); (A.M.V.d.S.); (A.P.D.A.B.)
| | - Monique da Rocha Queiroz Lima
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (M.d.R.Q.L.); (L.M.d.O.-P.)
| | - Christophe Paupy
- MIVEGEC, CNRS, Institut de Recherche pour le Développement (IRD), Université de Montpellier, 34394 Montpellier, France; (T.P.d.S.); (C.P.)
| | | | - Ana Paula Dinis Ano Bom
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (C.B.F.); (A.M.V.d.S.); (A.P.D.A.B.)
| | - Luzia Maria de Oliveira-Pinto
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (M.d.R.Q.L.); (L.M.d.O.-P.)
| | - Sara Moutailler
- UMR BIPAR, Animal Health Laboratory, ANSES, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris-Est, 94700 Maisons-Alfort, France; (L.Y.); (S.M.)
| | - Monique de Albuquerque Motta
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
| | - Márcia Gonçalves Castro
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
| | - Myrna Cristina Bonaldo
- Laboratório de Biologia Molecular de Flavivirus, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (I.P.R.); (A.A.C.d.S.); (M.C.B.)
| | - Sheila Maria Barbosa de Lima
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, Rio de Janeiro 21040-900, Brazil; (A.d.S.A.); (J.H.R.L.); (V.d.O.S.); (E.H.M.); (S.M.B.d.L.)
| | - Ricardo Lourenço-de-Oliveira
- Laboratório de Mosquitos Transmissores de Hematozoários, Instituto Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil; (F.V.S.d.A.); (A.F.-d.-B.); (M.S.A.S.N.); (M.Q.G.); (M.d.A.M.); (M.G.C.)
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Mata VE, Passos SRL, Santos MABD, Buonora SN, de Andrade CAF, Lima MDRQ, Costa BM, Hökerberg YHM. Diagnostic parameters and reliability of four rapid immunochromatographic tests for dengue 4. Braz J Infect Dis 2020; 24:58-64. [PMID: 31954721 PMCID: PMC9392029 DOI: 10.1016/j.bjid.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/09/2019] [Accepted: 12/15/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although performance of rapid immunochromatographic tests (RITs) for dengue virus (DENV) serotypes 1, 2 and 3 is relatively settled, evidence on accuracy of RITs for DENV-4 are based on studies with small sample sizes and with discrepant results. OBJECTIVES To assess accuracy and inter-observer agreement of RITs targeting dengue nonstructural protein-1 (NS1) antigen - Dengue NS1-Bioeasy™, Dengue NS1 Ag Strip-Bio-Rad™, IVB Dengue Ag NS1-Orangelife™ and Dengue NS1-K130-Bioclin™ in DENV-4 samples. METHODS Study sample (n = 324) included adults presenting at an emergency unit in Rio de Janeiro, Brazil, with fever of ≤72 h and two or more dengue symptoms. A serum sample from each patient was tested by each RIT. A positive reverse-transcription polymerase chain reaction was considered as the reference standard for dengue diagnosis. The diagnostic parameters analyzed for each RIT were sensitivity, specificity, positive and negative predictive values, and likelihood ratios. Each RIT was read by homogeneous (two junior nurses) or heterogeneous (one junior nurse and one senior biologist) pairs. Agreement was estimated by simple kappa with 95% confidence interval, positive (Ppos) and negative (Pneg) proportion concordance and prevalence and bias adjusted kappa, rated from poor (k < 0.0) to almost perfect (0.8 < k < 1.0), and perfect (k = 1). RESULTS NS1 RITs for DENV-4 diagnosis showed high specificity (95.9%-99.4%), but low sensitivity (14.7%-45.4%). Bioeasy™ had the best performance, with a positive likelihood ratio of 26.0 (95% CI: 8.4;81.0). Inter-observer agreement was almost perfect for all evaluated RITs. Mismatches in confirmed dengue were more common for the Bioclin™ (Ppos 88.3-90.0 %) and Orangelife™ (Ppos 91.7-94.1 %) tests. CONCLUSIONS For DENV-4, the tested RITs had high specificity, but lower sensitivity compared to published results for other serotypes. They should not be used for screening purposes. Different brands may have very different performances. This should be considered upon deciding of using RITs in DENV-4 outbreaks.
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Affiliation(s)
- Veronica Elizabeth Mata
- Oswaldo Cruz Foundation, Evandro Chagas National Institute of Infectious Diseases, Laboratory of Clinical Epidemiology, Rio de Janeiro, RJ, Brazil
| | - Sonia Regina Lambert Passos
- Oswaldo Cruz Foundation, Evandro Chagas National Institute of Infectious Diseases, Laboratory of Clinical Epidemiology, Rio de Janeiro, RJ, Brazil.
| | | | - Sibelle Nogueira Buonora
- Oswaldo Cruz Foundation, Evandro Chagas National Institute of Infectious Diseases, Laboratory of Clinical Epidemiology, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Yara Hahr Marques Hökerberg
- Oswaldo Cruz Foundation, Evandro Chagas National Institute of Infectious Diseases, Laboratory of Clinical Epidemiology, Rio de Janeiro, RJ, Brazil
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Lima MDRQ, Chouin-Carneiro T, Azeredo E, Barbosa LS, Souza TMA, Silva JBCD, Nunes PCG, Dal Fabbro M, Facco IHR, Venâncio-da-Cunha R, Dos Santos FB. The inability of a dengue NS1 ELISA to detect Zika infections. Sci Rep 2019; 9:18596. [PMID: 31819129 PMCID: PMC6901494 DOI: 10.1038/s41598-019-55160-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 11/25/2019] [Indexed: 12/27/2022] Open
Abstract
The presence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) in Brazil, may result in a difficult diagnosis due to the signs and symptoms shared by those. Moreover, as DENV and ZIKV belong to the same family, serological assays may show a high rate of cross-reactivity. Here, we evaluated a Dengue NS1 capture assay for early and differential diagnosis of dengue during the Zika epidemic occurred in Brazil in 2016. Samples (n = 227) from 218 patients included sera, plasma and urine from previously confirmed acute cases of Zika, dengue and Zika/dengue co-infections. Nine of those patients presented two specimens. The Dengue NS1 test was very specific for dengue diagnosis (99.32%), even in the co-circulation with ZIKV, and exhibited a high accuracy in not detecting acute Zika infections (92.43%). Our findings showed that the dengue NS1 capture test analyzed here was not able to recognize the ZIKV NS1 and its potential for cross-reaction.
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Affiliation(s)
| | - Thais Chouin-Carneiro
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, 21045-360, Brazil
| | - Elzinandes Azeredo
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, 21045-360, Brazil
| | | | | | | | | | - Márcia Dal Fabbro
- Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo Grande, 79070-900, Brazil
| | | | - Rivaldo Venâncio-da-Cunha
- Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo Grande, 79070-900, Brazil
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Gonçalves BDS, Horta MAP, Acero PHC, Bochner R, Queiroz Lima MDR, de Araújo ES, Sampaio SA, Nogueira RMR, de Filippis AMB. Dynamics of nonstructural glycoprotein-1 in dengue patients presenting with different clinical manifestations from 1986 to 2012 in Rio de Janeiro, Brazil. J Med Virol 2018; 91:555-563. [DOI: 10.1002/jmv.25356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/06/2018] [Indexed: 01/12/2023]
Affiliation(s)
| | | | | | - Rosany Bochner
- Laboratory of Scientific and Technological Information in Health; Institute of Communication and Scientific and Technological Information in Health/ FIOCRUZ; Rio de Janeiro Brazil
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9
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de Souza TMA, Ribeiro ED, Corrêa VCE, Damasco PV, Santos CC, de Bruycker-Nogueira F, Chouin-Carneiro T, Faria NRDC, Nunes PCG, Heringer M, Lima MDRQ, Badolato-Corrêa J, Cipitelli MDC, Azeredo ELD, Nogueira RMR, Dos Santos FB. Following in the Footsteps of the Chikungunya Virus in Brazil: The First Autochthonous Cases in Amapá in 2014 and Its Emergence in Rio de Janeiro during 2016. Viruses 2018; 10:v10110623. [PMID: 30424530 PMCID: PMC6266966 DOI: 10.3390/v10110623] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/30/2018] [Accepted: 11/02/2018] [Indexed: 12/19/2022] Open
Abstract
Currently, Brazil lives a triple arboviruses epidemic (DENV, ZIKV and CHIKV) making the differential diagnosis difficult for health professionals. Here, we aimed to investigate chikungunya cases and the possible occurrence of co-infections during the epidemic in Amapá (AP) that started in 2014 when the first autochthonous cases were reported and in Rio de Janeiro (RJ) in 2016. We further performed molecular characterization and genotyping of representative strains. In AP, 51.4% of the suspected cases were confirmed for CHIKV, 71.0% (76/107). Of those, 24 co-infections by CHIKV/DENV, two by CHIKV/DENV-1, and two by CHIKV/DENV-4 were observed. In RJ, 76.9% of the suspected cases were confirmed for CHIKV and co-infections by CHIKV/DENV (n = 8) and by CHIKV/ZIKV (n = 17) were observed. Overall, fever, arthralgia, myalgia, prostration, edema, exanthema, conjunctival hyperemia, lower back pain, dizziness, nausea, retroorbital pain, and anorexia were the predominating chikungunya clinical symptoms described. All strains analyzed from AP belonged to the Asian genotype and no amino acid changes were observed. In RJ, the East-Central-South-African genotype (ECSA) circulation was demonstrated and no E1-A226V mutation was observed. Despite this, an E1-V156A substitution was characterized in two samples and for the first time, the E1-K211T mutation was reported in all samples analyzed.
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Affiliation(s)
| | | | | | - Paulo Vieira Damasco
- Rio-Laranjeiras Hospital, 22240-000 Rio de Janeiro, Brazil.
- Gaffrée Guinle University Hospital, Federal University of the State of Rio de Janeiro, 20270-003 Rio de Janeiro, Brazil.
- Pedro Ernesto University Hospital, University of the State of Rio de Janeiro, 20551-030 Rio de Janeiro, Brazil.
| | | | | | - Thaís Chouin-Carneiro
- Viral Immunology Laboratory, Oswaldo Cruz Institute, 21040-360 Rio de Janeiro, Brazil.
| | | | | | - Manoela Heringer
- Viral Immunology Laboratory, Oswaldo Cruz Institute, 21040-360 Rio de Janeiro, Brazil.
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10
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Nunes PCG, Nogueira RMR, Heringer M, Chouin-Carneiro T, Damasceno Dos Santos Rodrigues C, de Filippis AMB, Lima MDRQ, Dos Santos FB. NS1 Antigenemia and Viraemia Load: Potential Markers of Progression to Dengue Fatal Outcome? Viruses 2018; 10:E326. [PMID: 29903980 PMCID: PMC6024368 DOI: 10.3390/v10060326] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/22/2018] [Accepted: 03/01/2018] [Indexed: 01/29/2023] Open
Abstract
Dengue is a worldwide problem characterized by a multifactorial pathogenesis. Considering the viral components, it is known that high viremia or high levels of the secreted nonstructural protein 1 (NS1) may be associated with a more severe disease. We aimed to characterize the NS1 antigenemia and viremia in dengue fatal and non-fatal cases, as potential markers of progression to a fatal outcome. NS1 antigenemia and viremia were determined in Brazilian dengue fatal cases (n = 40) and non-fatal cases (n = 40), representative of the four dengue virus (DENV) serotypes. Overall, the fatal cases presented higher NS1 levels and viremia. Moreover, the fatal cases from secondary infections showed significantly higher NS1 levels than the non-fatal ones. Here, irrespective of the disease outcome, DENV-1 cases presented higher NS1 levels than the other serotypes. However, DENV-2 and DENV-4 fatal cases had higher NS1 antigenemia than the non-fatal cases with the same serotype. The viremia in the fatal cases was higher than in the non-fatal ones, with DENV-3 and DENV-4 presenting higher viral loads. Viral components, such as NS1 and viral RNA, may be factors influencing the disease outcome. However, the host immune status, comorbidities, and access to adequate medical support cannot be ruled out as interfering in the disease outcome.
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Affiliation(s)
- Priscila Conrado Guerra Nunes
- Viral Immunology Laboratory (LIV), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
- Flavivirus Laboratory (LABFLA), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Rita Maria Ribeiro Nogueira
- Flavivirus Laboratory (LABFLA), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Manoela Heringer
- Viral Immunology Laboratory (LIV), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Thaís Chouin-Carneiro
- Viral Immunology Laboratory (LIV), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
- Hematozoa Transmittors Mosquitoes Laboratory, Oswaldo Cruz Institute, Rio de Janeiro 21040-360, Brazil.
| | | | - Ana Maria Bispo de Filippis
- Flavivirus Laboratory (LABFLA), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Monique da Rocha Queiroz Lima
- Viral Immunology Laboratory (LIV), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
| | - Flávia Barreto Dos Santos
- Viral Immunology Laboratory (LIV), Oswaldo Cruz Institute-FIOCRUZ, Avenida Brasil, 4365. Manguinhos, Rio de Janeiro 21040-360, Brazil.
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Badolato‐Corrêa J, Sánchez‐Arcila JC, Alves de Souza TM, Santos Barbosa L, Conrado Guerra Nunes P, da Rocha Queiroz Lima M, Gandini M, Bispo de Filippis AM, Venâncio da Cunha R, Leal de Azeredo E, de‐Oliveira‐Pinto LM. Human T cell responses to Dengue and Zika virus infection compared to Dengue/Zika coinfection. Immun Inflamm Dis 2018; 6:194-206. [PMID: 29282904 PMCID: PMC5946158 DOI: 10.1002/iid3.203] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/13/2017] [Accepted: 10/04/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Zika virus (ZIKV) and dengue virus (DENV) co-circulated during latest outbreaks in Brazil, hence, it is important to evaluate the host cross-reactive immune responses to these viruses. So far, little is known about human T cell responses to ZIKV and no reports detail adaptive immune responses during DENV/ZIKV coinfection. METHODS Here, we studied T cells responses in well-characterized groups of DENV, ZIKV, or DENV/ZIKV infected patients and DENV-exposed healthy donors. We evaluated chemokine receptors expression and single/multifunctional frequencies of IFNγ, TNF, and IL2-producing T cells during these infections. Even without antigenic stimulation, it was possible to detect chemokine receptors and IFNγ, TNF, and IL2-producing T cells from all individuals by flow cytometry. Additionally, PBMCs' IFNγ response to DENV NS1 protein and to polyclonal stimuli was evaluated by ELISPOT. RESULTS DENV and ZIKV infections and DENV/ZIKV coinfections similarly induced expression of CCR5, CX3CR1, and CXCR3 on CD4 and CD8 T cells. DENV/ZIKV coinfection decreased the ability of CD4+ T cells to produce IFNγ+ , TNF+ , TNF + IFNγ+ , and TNF + IL2+ , compared to DENV and ZIKV infections. A higher magnitude of IFNγ response to DENV NS1 was found in donors with a history of dengue infection, however, a hyporesponsiveness was found in acute DENV, ZIKV, or DENV/ZIKV infected patients, even previously infected with DENV. CONCLUSION Therefore, we emphasize the potential impact of coinfection on the immune response from human hosts, mainly in areas where DENV and ZIKV cocirculate.
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Affiliation(s)
- Jessica Badolato‐Corrêa
- Laboratory of Viral ImmunologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
| | | | | | - Luciana Santos Barbosa
- Laboratory of Viral ImmunologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
- Laboratory of Genetics, Institute of Paediatrics and Puericulture Martagão Gesteira (IPPMG)Federal University of Rio de Janeiro, UFRJRio de JaneiroBrazil
| | | | | | - Mariana Gandini
- Laboratory of Cellular MicrobiologyFundação Oswaldo CruzInstituto Oswaldo CruzRio de JaneiroBrazil
| | | | - Rivaldo Venâncio da Cunha
- Department of Clinical MedicineUniversidade Federal do Mato Grosso do SulBrazil
- Fundação Oswaldo CruzCampo GrandeMato Grosso do SulBrazil
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da Costa Faria NR, Solorzano VEF, de Souza LJ, Nogueira RMR, de Bruycker-Nogueira F, Chouin-Carneiro T, Santos Simões JB, da Rocha Queiroz Lima M, de Oliveira Pinto LM, Kubelka CF, Heringer M, de Azeredo EL, Barreto Dos Santos F. Analysis of Clinical and Laboratory Alterations Related to Dengue Case Severity: Comparison between Serotypes 2 and 4 in Brazil. Am J Trop Med Hyg 2017; 97:137-145. [PMID: 28719315 DOI: 10.4269/ajtmh.16-0227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The increase in severe dengue (SD) cases has caused great impact on public health and has concerned authorities of countries where the disease is endemic and epidemics reach high proportions. The recognition of progression signs of this severe disease during the initial febrile phase can be difficult, since the symptoms are often indistinguishable from other febrile diseases. The aim of this study was to evaluate the clinical manifestations and laboratory findings in patients from two dengue outbreaks and their association with the disease. The study was conducted in patients (n = 153) with signs and symptoms consistent with dengue occurred during two distinct epidemics, 2010 and 2013, in the city of Campos dos Goytacazes, Rio de Janeiro, Brazil. According to the 2009 World Health Organization criteria, patients were classified as dengue without warning signs ([DwoWS] 60.6%, 57/94), dengue with warning signs ([DwWS] 30.9%, 29/94), and SD (4.25%, 4/94). Patients with DwWS/SD presented lower platelet and leukocyte counts and higher transaminase levels when compared with the DwoWS ones. Interestingly, patients from the epidemic of 2010 caused by dengue virus 2 (DENV-2) had lower platelet counts than patients of the 2013 epidemic caused by DENV-4. Furthermore, plasma leakage, gastrointestinal bleeding, and pleural effusion, hallmarks for a more severe disease, were also more frequently observed in those cases. Although previous studies may have extensively reported the wide range of the clinical aspects of dengue, the characterization of DENV-4 is desirable considering the burden of the disease during epidemics, especially for the health units and hospitals performing patient's management.
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Affiliation(s)
- Nieli Rodrigues da Costa Faria
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | - Luiz José de Souza
- Flavivirus Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Rita Maria Ribeiro Nogueira
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Fernanda de Bruycker-Nogueira
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Thaís Chouin-Carneiro
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Jaqueline Bastos Santos Simões
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Monique da Rocha Queiroz Lima
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | | | - Manoela Heringer
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | - Flavia Barreto Dos Santos
- Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil Oswaldo Cruz Institute, Rio de Janeiro, Brazil
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13
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Faria NRDC, Solorzano VEF, Nogueira RMR, Chouin-Carneiro T, Nunes PCG, Simões JBS, de Bruycker Nogueira F, Lima MDRQ, de Oliveira Pinto LM, Kubelka CF, da Cunha RV, de Azeredo EL, dos Santos FB. Dengue epidemics in two distinct periods reveal distinct epidemiological, laboratorial and clinical aspects in a same scenario: analysis of the 2010 and 2013 epidemics in Mato Grosso do Sul, Brazil. Trans R Soc Trop Med Hyg 2016; 110:228-36. [PMID: 26956779 DOI: 10.1093/trstmh/trw013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 01/20/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dengue is a major problem in Brazil. Epidemiological and clinical aspects were characterized in patients from two epidemics which occurred in Mato Grosso do Sul, Brazil. METHODS Dengue cases were classified according to the 2009 WHO criteria, tested by serological and molecular biology tests and analysed for nonstructural protein 1 (NS1) antigenemia. RESULTS Dengue was confirmed in 78.7% (48/61) and 75.6% (118/156) of the cases studied in 2010 and 2013, respectively. DENV-1 and DENV-2 were the serotypes involved in the 2010 epidemic and DENV-4 in the 2013 one. Most of the cases were classified as dengue without warning; however, severe dengue was observed in 18.7% (9/48) of the cases in 2010 and less observed in DENV-4 cases. NS1 levels were higher in patients with dengue with warning signs and severe dengue in 2010. Circulating aspartate aminotransferase (AST) and alanine transferase (ALT) were altered in all groups, independently of the infecting serotype or epidemic. Patients with DENV-1 and DENV-2 presented significant lower monocyte counts when compared to patients with DENV-4. An inverse correlation was found between platelet count, leucocytes, monocytes and NS1 levels. CONCLUSIONS Epidemics caused by the prevalence of distinct DENV serotypes had different impacts and clinical characteristics in a same scenario and, despite the occurrence of secondary infections, the DENV-4 emergence was not associated with severe cases.
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Affiliation(s)
- Nieli Rodrigues da Costa Faria
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil Imunnology Viral Laboratory Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | | | - Rita Maria Ribeiro Nogueira
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Thaís Chouin-Carneiro
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Priscila Conrado Guerra Nunes
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Jaqueline Bastos Santos Simões
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Fernanda de Bruycker Nogueira
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | - Monique da Rocha Queiroz Lima
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
| | | | | | | | | | - Flavia Barreto dos Santos
- Flavivirus Laboratory, Oswaldo Cruz Institute/FIOCRUZ, Av Brasil 4365, Manguinhos, Rio de Janeiro, RJ, 21045-360, Brazil
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Nunes PCG, Sampaio SAF, da Costa NR, de Mendonça MCL, Lima MDRQ, Araujo SEM, dos Santos FB, Simões JBS, Gonçalves BDS, Nogueira RMR, de Filippis AMB. Dengue severity associated with age and a new lineage of dengue virus-type 2 during an outbreak in Rio De Janeiro, Brazil. J Med Virol 2016; 88:1130-6. [PMID: 27061403 DOI: 10.1002/jmv.24464] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 02/03/2023]
Abstract
Dengue virus-type 2 (DENV-2) caused three outbreaks, in the years 1990, 1998, and 2008, in Rio de Janeiro, Brazil. The 2008 outbreak was the most severe in reported cases, hospitalizations, and deaths. To investigate virological and epidemiological factors that may have contributed to the pathogenic profile of 2008 epidemic, 102 patients sera obtained during the epidemic and inter-epidemic periods of three outbreaks were analysed by qRT-PCR to estimate viremia levels and their correlation with the clinical, immunological, and demographic patient characteristics. DENV-2 isolates from the outbreaks were sequenced. Two DENV-2 lineages (I and II) of the American/Asian genotype were confirmed, each exclusive for 1990-2002 and 2007-2011, respectively. The mean viremia level in the 2008 samples was two orders of magnitude higher than that of the 1990-2002 samples. Severe dengue cases increased from 31% in 1990-2002 to 69% in 2007-2011; in patients aged ≤15 years, from 3% in 1990-2002 to 37% in 2007-2011. The DENV-2 lineage II and younger age significantly contributed to the pathogenic profile of 2008 epidemic in Rio de Janeiro.
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Affiliation(s)
| | | | | | | | | | - Saraiva Eliane M Araujo
- Flavivirus Laboratory, Oswaldo Cruz Foundation/Oswaldo Cruz Institute, Rio de Janeiro, Brazil
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15
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Nunes PCG, Paes MV, de Oliveira CAB, Soares ACG, de Filippis AMB, Lima MDRQ, de Barcelos Alves AM, da Silva JFA, de Oliveira Coelho JMC, de Carvalho Rodrigues FDC, Nogueira RMR, Dos Santos FB. Detection of dengue NS1 and NS3 proteins in placenta and umbilical cord in fetal and maternal death. J Med Virol 2016; 88:1448-52. [PMID: 26792253 DOI: 10.1002/jmv.24479] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2016] [Indexed: 01/07/2023]
Abstract
In Brazil, dengue is a public health problem with the occurrence of explosive epidemics. This study reports maternal and fetal deaths due to dengue and which tissues of placenta and umbilical cord were analyzed by molecular methods and immunohistochemistry. The dengue NS3 and NS1 detection revealed the viral presence in different cells from placenta and umbilical cord. In the latter, DENV-2 was detected at a viral titer of 1,02 × 10(4) amounts of viral RNA. It was shown that the DENV markers analyzed here may be an alternative approach for dengue fatal cases investigation, especially involving maternal and fetal death. J. Med. Virol. 88:1448-1452, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Marciano Viana Paes
- Laboratório de Biotecnologia e Fisiologia de Infecções Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
| | - Carlos Alberto Basilio de Oliveira
- Hospital Universitário Gaffrée Guinle, Departamento de Anatomia Patológica, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Carla Gomes Soares
- Subsecretaria de Atenção Primária, Vigilância e Promoção da Saúde, Secretaria Municipal de Saúde do Rio de Janeiro-RJ, Brazil
| | - Ana Maria Bispo de Filippis
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
| | | | - Ada Maria de Barcelos Alves
- Laboratório de Biotecnologia e Fisiologia de Infecções Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
| | - Juliana Fernandes Amorim da Silva
- Laboratório de Biotecnologia e Fisiologia de Infecções Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
| | | | | | - Rita Maria Ribeiro Nogueira
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
| | - Flávia Barreto Dos Santos
- Laboratório de Flavivirus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz /FIOCRUZ, Rio de Janeiro- RJ, Brazil
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16
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Lima MDRQ, Nogueira RMR, Filippis AMBD, Nunes PCG, Sousa CSD, Silva MHD, Santos FBD. A simple heat dissociation method increases significantly the ELISA detection sensitivity of the nonstructural-1 glycoprotein in patients infected with DENV type-4. J Virol Methods 2014; 204:105-8. [DOI: 10.1016/j.jviromet.2014.02.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 02/18/2014] [Accepted: 02/21/2014] [Indexed: 12/14/2022]
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17
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Maldaner FR, Aragão FJL, dos Santos FB, Franco OL, da Rocha Queiroz Lima M, de Oliveira Resende R, Vasques RM, Nagata T. Dengue virus tetra-epitope peptide expressed in lettuce chloroplasts for potential use in dengue diagnosis. Appl Microbiol Biotechnol 2013; 97:5721-9. [PMID: 23615743 DOI: 10.1007/s00253-013-4918-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 04/04/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
Dengue virus causes about 100 million cases of dengue disease per year in the world. Laboratory diagnosis is done mainly by serological techniques, which in many cases use crude virus extracts that may cause cross-reactions to other flaviviruses. These undesirable cross-reactions can be reduced or eliminated by using recombinant proteins based on restricted epitopes. Aiming to decrease flaviviral cross-reactions and non-specific interactions in dengue serological assays, a plant expression system was chosen for recombinant antigen production as a reliable and inexpensive dengue diagnostic tool. In the present report, the lettuce plastid transformation system was applied to achieve efficient and stable tetra-epitope peptide antigen production, and its reactivity was evaluated. For this purpose, one putative epitope at positions 34 to 57 of E protein within the junction site of domains I and II of dengue virus (DENV) 1 to 4 serotypes linked by glycine linkers was expressed in lettuce chloroplasts. The potential immunoreactivity for the four DENV serotypes was evaluated using sera from patients of positive and negative dengue cases. Results indicated an overall sensitivity of 71.7% and specificity of 100%. No cross-reactions with the sera of yellow fever-positive or healthy individuals vaccinated against yellow fever were observed. This novel approach may provide an alternative system for the large-scale production of dengue recombinant antigens useful for serodiagnosis.
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Affiliation(s)
- Franciele Roberta Maldaner
- Departamento de Patologia Molecular, Universidade de Brasília, 70910-900 Brasília, Federal District, Brazil
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18
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Castro MGD, Nogueira RMR, Filippis AMBD, Ferreira AA, Lima MDRQ, Faria NRDC, Nogueira FDB, Simões JBS, Nunes PCG, Sampaio SA, Lourenço-de-Oliveira R, Santos FBD. Dengue virus type 4 in Niterói, Rio de Janeiro: the role of molecular techniques in laboratory diagnosis and entomological surveillance. Mem Inst Oswaldo Cruz 2013; 107:940-5. [PMID: 23147153 DOI: 10.1590/s0074-02762012000700017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/15/2012] [Indexed: 11/22/2022] Open
Abstract
In Niterói, state of Rio de Janeiro, dengue virus type 4 (DENV-4) was isolated for the first time in March 2011. We analysed the laboratory findings of the first cases and evaluated the use of molecular techniques for the detection of DENV-4 in Aedes aegypti that were field-caught. Conventional reverse transcriptase-polymerase chain reaction (RT-PCR) and Simplexa™ Dengue real-time RT-PCR confirmed DENV-4 infection in all cases. Additionally, DENV-4 was confirmed in a female Ae. aegypti with 1.08 x 10(3) copies/mL of virus, as determined by quantitative real-time RT-PCR. This is the first time the Simplexa™ Dengue real-time assay has been used for the classification of cases of infection and for entomological investigations. The use of these molecular techniques was shown to be important for the surveillance of dengue in humans and vectors.
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Faria NRDC, Nogueira RMR, de Filippis AMB, Simões JBS, Nogueira FDB, da Rocha Queiroz Lima M, dos Santos FB. Twenty years of DENV-2 activity in Brazil: molecular characterization and phylogeny of strains isolated from 1990 to 2010. PLoS Negl Trop Dis 2013; 7:e2095. [PMID: 23516646 PMCID: PMC3597488 DOI: 10.1371/journal.pntd.0002095] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/22/2013] [Indexed: 11/18/2022] Open
Abstract
In Brazil, dengue has been a major public health problem since its introduction in the 1980s. Phylogenetic studies constitute a valuable tool to monitor the introduction and spread of viruses as well as to predict the potential epidemiological consequences of such events. Aiming to perform the molecular characterization and phylogenetic analysis of DENV-2 during twenty years of viral activity in the country, viral strains isolated from patients presenting different disease manifestations (n = 34), representing six states of the country, from 1990 to 2010, were sequenced. Partial genome sequencing (genes C/prM/M/E) was performed in 25 DENV-2 strains and full-length genome sequencing (coding region) was performed in 9 strains. The percentage of similarity among the DENV-2 strains in this study and reference strains available in Genbank identified two groups epidemiologically distinct: one represented by strains isolated from 1990 to 2003 and one from strains isolated from 2007 to 2010. No consistent differences were observed on the E gene from strains isolated from cases with different clinical manifestations analyzed, suggesting that if the disease severity has a genetic origin, it is not only due to the differences observed on the E gene. The results obtained by the DENV-2 full-length genome sequencing did not point out consistent differences related to a more severe disease either. The analysis based on the partial and/or complete genome sequencing has characterized the Brazilian DENV-2 strains as belonging to the Southeast Asian genotype, however a distinction of two Lineages within this genotype has been identified. It was established that strains circulating prior DENV-2 emergence (1990–2003) belong to Southeast Asian genotype, Lineage I and strains isolated after DENV-2 emergence in 2007 belong to Southeast Asian genotype, Lineage II. Furthermore, all DENV-2 strains analyzed presented an asparagine (N) in E390, previously identified as a probable genetic marker of virulence observed in DHF strains from Asian origin. The percentage of identity of the latter with the Dominican Republic strain isolated in 2001 combined to the percentage of divergence with the strains first introduced in the country in the 1990s suggests that those viruses did not evolve locally but were due to a new viral Lineage introduction in the country from the Caribbean. In Brazil, the first dengue haemorrhagic cases were reported after the DENV-2 introduction in Rio de Janeiro, which spread to other states in the country. Aiming to perform the molecular characterization and phylogenetic analysis of DENV-2 during twenty years of viral activity in the country, strains isolated from patients presenting different disease manifestations were sequenced. Phylogeny characterized the DENV-2 as belonging to the Southeast Asian genotype, however a distinction of two Lineages within this genotype has been identified. Furthermore, all strains presented an asparagine in E390, previously identified as a probable genetic marker of virulence. The results show a temporal circulation of genetically different viruses in Brazil, probably due to the introduction of a new viral lineage from the Caribbean, which lead to the re-emergence of this serotype after 2007, causing the most severe epidemic already described in the country.
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Affiliation(s)
| | | | | | | | | | | | - Flavia Barreto dos Santos
- Flavivirus Laboratory, Oswaldo Cruz Institute, Manguinhos, Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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Lima MDRQ, Nogueira RMR, Schatzmayr HG, de Filippis AMB, Limonta D, dos Santos FB. A new approach to dengue fatal cases diagnosis: NS1 antigen capture in tissues. PLoS Negl Trop Dis 2011; 5:e1147. [PMID: 21572520 PMCID: PMC3086804 DOI: 10.1371/journal.pntd.0001147] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 03/21/2011] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED / BACKGROUND Dengue is the most important arthropod borne viral disease worldwide in terms of morbidity and mortality and is caused by any of the four serotypes of dengue virus (DENV-1 to 4). Brazil is responsible for approximately 80% of dengue cases in the Americas, and since the introduction of dengue in 1986, a total of 5,944,270 cases have been reported including 21,596 dengue hemorrhagic fever and 874 fatal cases. DENV can infect many cell types and cause diverse clinical and pathological effects. The goal of the study was to investigate the usefulness of NS1 capture tests as an alternative tool to detect DENV in tissue specimens from previously confirmed dengue fatal cases (n = 23) that occurred in 2002 in Brazil. METHODOLOGY/PRINCIPAL FINDINGS A total of 74 tissue specimens were available: liver (n = 23), lung (n = 14), kidney (n = 04), brain (n = 10), heart (n = 02), skin (n = 01), spleen (n = 15), thymus (n = 03) and lymph nodes (n = 02). We evaluated three tests for NS1 antigen capture: first generation Dengue Early ELISA (PanBio Diagnostics), Platelia NS1 (BioRad Laboratories) and the rapid test NS1 Ag Strip (BioRad Laboratories). The overall dengue fatal case diagnosis based on the tissues analyzed by Dengue Early ELISA, Platelia NS1 and the NS1 Ag Strip was 34.7% (08/23), 60.8% (14/23) and 91.3% (21/23), respectively. The Dengue Early ELISA detected NS1 in 22.9% (17/74) of the specimens analyzed and the Platelia NS1 in 45.9% (34/74). The highest sensitivity (78.3%; 58/74) was achieved by the NS1 Ag Strip, and the differences in the sensitivities were statistically significant (p<0.05). The NS1 Ag Strip was the most sensitive in liver (91.3%; 21/23), lung (71.4%; 10/14), kidney (100%; 4/4), brain (80%; 8/10), spleen (66.6%, 10/15) and thymus (100%, 3/3) when compared to the other two ELISA assays. CONCLUSIONS/SIGNIFICANCE This study shows the DENV NS1 capture assay as a rapid and valuable approach to postmortem dengue confirmation. With an increasing number of DHF and fatal cases, the availability of new approaches useful for cases confirmation plays an important tool for the disease surveillance.
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Affiliation(s)
| | | | | | | | - Daniel Limonta
- National Reference Laboratory for Dengue, Virology Department, PAHO/WHO
Collaborating Center for the Study of Dengue and Its Vector, Pedro Kourí
Institute of Tropical Medicine, Havana, Cuba
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Lima MDRQ, Nogueira RMR, Schatzmayr HG, dos Santos FB. Comparison of three commercially available dengue NS1 antigen capture assays for acute diagnosis of dengue in Brazil. PLoS Negl Trop Dis 2010; 4:e738. [PMID: 20625558 PMCID: PMC2897844 DOI: 10.1371/journal.pntd.0000738] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Accepted: 05/24/2010] [Indexed: 01/17/2023] Open
Abstract
Background Dengue is associated with explosive urban epidemics and has become a major public health problem in many tropical developing countries, including Brazil. The laboratory diagnosis of dengue can be carried out using several approaches, however sensitive and specific assays useful to diagnose in the early stage of fever are desirable. The flavivirus non-structural protein NS1, a highly conserved and secreted glycoprotein, is a candidate protein for rapid diagnosis of dengue in endemic countries. Methodology/Principal Findings We aimed to evaluate the potential use of 3 commercial kits in a panel of 450 serum samples for early diagnosis of dengue in Brazil. The PanBio Early ELISA (PanBio Diagnostics) showed a sensitivity of 72.3% (159/220) and a specificity of 100%, while the sensitivity of the Platelia™ NS1 assay (Biorad Laboratories) was 83.6% (184/220). However, the highest sensitivity (89.6%; 197/220) was obtained by using the NS1 Ag Strip (Biorad Laboratories). A lower sensitivity was observed in DENV-3 cases by all 3 kits. Serum positive by virus isolation were more often positive than cases positive by RT-PCR by all three assays and a higher detection rate was observed during the first four days after the onset of the symptoms. The presence or absence of IgM showed no influence in the confirmation by the pan-E Early ELISA (P = 0,6159). However, a higher confirmation by both Platelia™ NS1 (Biorad) and Dengue NS1 Ag Strip (Biorad) in the absence of IgM was statistically significant (P<0,0001 and P = 0,0008, respectively). Only the Platelia™ NS1 test showed a higher sensitivity in confirming primary infections than secondary ones. Conclusions/Significance The results indicate that commercial kits of dengue NS1 antigen are useful for the laboratory diagnosis of acute primary and secondary dengue. It can be used in combination with the MAC-ELISA for case detection and as screening test to complement viral isolation. Dengue is the one of the most prevalent arthropod-borne viral diseases in tropical regions of the world. Manifestations may vary from asymptomatic to potentially fatal complications. Laboratorial diagnosis is essential to diagnose dengue and differentiate it from other diseases. Dengue virus non-structural protein 1 (NS1) may be used as a marker of acute dengue virus infection. Our results, based in the comparison of three NS1 antigen capture assays available, have shown that this approach is reliable for the early diagnosis of dengue infections, especially in the first four days after the onset of the symptoms. A lower sensitivity was observed in DENV-3 cases. Serum positive by virus isolation were more often detected than those positive by RT-PCR by all three assays. Only the Platelia™ NS1 test showed a higher sensitivity in confirming primary infections than secondary ones. In conclusion, NS1 antigen capture commercial kits are useful for diagnosis of acute primary and secondary dengue infections and, in endemic countries where secondary infections are expected to occur, may be used in combination with MAC-ELISA to increase the overall sensitivity of both tests.
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