1
|
Parker E, Thomas J, Roper KJ, Ijaz S, Edwards T, Marchesin F, Katsanovskaja K, Lett L, Jones C, Hardwick HE, Davis C, Vink E, McDonald SE, Moore SC, Dicks S, Jegatheesan K, Cook NJ, Hope J, Cherepanov P, McClure MO, Baillie JK, Openshaw PJM, Turtle L, Ho A, Semple MG, Paxton WA, Tedder RS, Pollakis G. SARS-CoV-2 antibody responses associate with sex, age and disease severity in previously uninfected people admitted to hospital with COVID-19: An ISARIC4C prospective study. Front Immunol 2023; 14:1146702. [PMID: 37056776 PMCID: PMC10087108 DOI: 10.3389/fimmu.2023.1146702] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
The SARS-CoV-2 pandemic enables the analysis of immune responses induced against a novel coronavirus infecting immunologically naïve individuals. This provides an opportunity for analysis of immune responses and associations with age, sex and disease severity. Here we measured an array of solid-phase binding antibody and viral neutralising Ab (nAb) responses in participants (n=337) of the ISARIC4C cohort and characterised their correlation with peak disease severity during acute infection and early convalescence. Overall, the responses in a Double Antigen Binding Assay (DABA) for antibody to the receptor binding domain (anti-RBD) correlated well with IgM as well as IgG responses against viral spike, S1 and nucleocapsid protein (NP) antigens. DABA reactivity also correlated with nAb. As we and others reported previously, there is greater risk of severe disease and death in older men, whilst the sex ratio was found to be equal within each severity grouping in younger people. In older males with severe disease (mean age 68 years), peak antibody levels were found to be delayed by one to two weeks compared with women, and nAb responses were delayed further. Additionally, we demonstrated that solid-phase binding antibody responses reached higher levels in males as measured via DABA and IgM binding against Spike, NP and S1 antigens. In contrast, this was not observed for nAb responses. When measuring SARS-CoV-2 RNA transcripts (as a surrogate for viral shedding) in nasal swabs at recruitment, we saw no significant differences by sex or disease severity status. However, we have shown higher antibody levels associated with low nasal viral RNA indicating a role of antibody responses in controlling viral replication and shedding in the upper airway. In this study, we have shown discernible differences in the humoral immune responses between males and females and these differences associate with age as well as with resultant disease severity.
Collapse
Affiliation(s)
- Eleanor Parker
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Jordan Thomas
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Kelly J. Roper
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Samreen Ijaz
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, London, United Kingdom
| | - Tansy Edwards
- Medical Research Council (MRC) International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Federica Marchesin
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Lauren Lett
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Christopher Jones
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Hayley E. Hardwick
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Chris Davis
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Elen Vink
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Sarah E. McDonald
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Shona C. Moore
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Steve Dicks
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, London, United Kingdom
- National Health Service (NHS) Blood and Transplant, London, United Kingdom
| | - Keerthana Jegatheesan
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, London, United Kingdom
- National Health Service (NHS) Blood and Transplant, London, United Kingdom
| | - Nicola J. Cook
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Joshua Hope
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, United Kingdom
| | - Myra O. McClure
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | | | | | - Lance Turtle
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Antonia Ho
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Malcolm G. Semple
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - William A. Paxton
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Richard S. Tedder
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Georgios Pollakis
- National Institute of Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | | |
Collapse
|
2
|
Ijaz S, Dicks S, Jegatheesan K, Parker E, Katsanovskaja K, Vink E, McClure MO, Shute J, Hope J, Cook N, Cherepanov P, Turtle L, Paxton WA, Pollakis G, Ho A, Openshaw PJM, Baillie JK, Semple MG, Tedder RS. Mapping of SARS-CoV-2 IgM and IgG in gingival crevicular fluid: Antibody dynamics and linkage to severity of COVID-19 in hospital inpatients. J Infect 2022; 85:152-160. [PMID: 35667482 PMCID: PMC9163047 DOI: 10.1016/j.jinf.2022.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Samreen Ijaz
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK.
| | - Steve Dicks
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; NHS Blood and Transplant, London, UK
| | - Keerthana Jegatheesan
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; NHS Blood and Transplant, London, UK
| | - Eleanor Parker
- Department of Infectious Disease, Imperial College London, London, UK
| | | | - Elen Vink
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Myra O McClure
- Department of Infectious Disease, Imperial College London, London, UK
| | - J Shute
- Blood Borne Virus Unit, Reference Department, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Joshua Hope
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Nicola Cook
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, London, UK; Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Lance Turtle
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - William A Paxton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Georgios Pollakis
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Antonia Ho
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | | | - Malcolm G Semple
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Department of Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, UK
| | - Richard S Tedder
- Department of Infectious Disease, Imperial College London, London, UK
| |
Collapse
|
3
|
Claudiani S, Apperley JF, Parker EL, Marchesin F, Katsanovskaja K, Palanicawandar R, Innes AJ, Tedder RS, McClure MO, Milojkovic D. Durable humoral responses after the second anti-SARS-CoV-2 vaccine dose in chronic myeloid leukaemia patients on tyrosine kinase inhibitors. Br J Haematol 2022; 197:e1-e4. [PMID: 34923623 DOI: 10.1111/bjh.18001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022]
Affiliation(s)
- Simone Claudiani
- Centre for Haematology, Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - Jane F Apperley
- Centre for Haematology, Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - Eleanor L Parker
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Renuka Palanicawandar
- Centre for Haematology, Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - Andrew J Innes
- Centre for Haematology, Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Dragana Milojkovic
- Centre for Haematology, Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, UK
| |
Collapse
|
4
|
Rosadas C, Khan M, Parker E, Marchesin F, Katsanovskaja K, Sureda-Vives M, Fernandez N, Randell P, Harvey R, Lilley A, Harris BHL, Zuhair M, Fertleman M, Ijaz S, Dicks S, Short CE, Quinlan R, Taylor GP, Hu K, McKay P, Rosa A, Roustan C, Zuckerman M, El Bouzidi K, Cooke G, Flower B, Moshe M, Elliott P, Spencer AJ, Lambe T, Gilbert SC, Kingston H, Baillie JK, Openshaw PJM, Semple MG, Cherepanov P, McClure MO, Tedder RS. Detection and quantification of antibody to SARS CoV 2 receptor binding domain provides enhanced sensitivity, specificity and utility. J Virol Methods 2022; 302:114475. [PMID: 35077719 PMCID: PMC8782753 DOI: 10.1016/j.jviromet.2022.114475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 01/10/2023]
Abstract
Accurate and sensitive detection of antibody to SARS-CoV-2 remains an essential component of the pandemic response. Measuring antibody that predicts neutralising activity and the vaccine response is an absolute requirement for laboratory-based confirmatory and reference activity. The viral receptor binding domain (RBD) constitutes the prime target antigen for neutralising antibody. A double antigen binding assay (DABA), providing the most sensitive format has been exploited in a novel hybrid manner employing a solid-phase S1 preferentially presenting RBD, coupled with a labelled RBD conjugate, used in a two-step sequential assay for detection and measurement of antibody to RBD (anti-RBD). This class and species neutral assay showed a specificity of 100 % on 825 pre COVID-19 samples and a potential sensitivity of 99.6 % on 276 recovery samples, predicting quantitatively the presence of neutralising antibody determined by pseudo-type neutralization and by plaque reduction. Anti-RBD is also measurable in ferrets immunised with ChadOx1 nCoV-19 vaccine and in humans immunised with both AstraZeneca and Pfizer vaccines. This assay detects anti-RBD at presentation with illness, demonstrates its elevation with disease severity, its sequel to asymptomatic infection and its persistence after the loss of antibody to the nucleoprotein (anti-NP). It also provides serological confirmation of prior infection and offers a secure measure for seroprevalence and studies of vaccine immunisation in human and animal populations. The hybrid DABA also displays the attributes necessary for the detection and quantification of anti-RBD to be used in clinical practice. An absence of detectable anti-RBD by this assay predicates the need for passive immune prophylaxis in at-risk patients.
Collapse
Affiliation(s)
- Carolina Rosadas
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Maryam Khan
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Eleanor Parker
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Federica Marchesin
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Macià Sureda-Vives
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Natalia Fernandez
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul Randell
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK
| | - Ruth Harvey
- Worldwide Influenza Centre, Francis Crick Institute, London, NW1 1AT, UK
| | - Alice Lilley
- Worldwide Influenza Centre, Francis Crick Institute, London, NW1 1AT, UK
| | - Benjamin H L Harris
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK; Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Mohamed Zuhair
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK
| | - Michael Fertleman
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, National Infection Service, Colindale Public Health England, London, NW9 5EQ, UK
| | - Steve Dicks
- Blood Borne Virus Unit, National Infection Service, Colindale Public Health England, London, NW9 5EQ, UK; Transfusion Microbiology, NHS Blood and Transplant, Lingard Avenue, London, NW9 5BG, UK
| | - Charlotte-Eve Short
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Rachael Quinlan
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Kai Hu
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul McKay
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Mark Zuckerman
- Department of Virology, King's College Hospital, London, SE5 9RS, UK
| | - Kate El Bouzidi
- Department of Virology, King's College Hospital, London, SE5 9RS, UK
| | - Graham Cooke
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Barnaby Flower
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Maya Moshe
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | | | - Teresa Lambe
- Jenner Institute, University of Oxford, ORCRB, Oxford, OX3 7DQ, UK
| | - Sarah C Gilbert
- Jenner Institute, University of Oxford, ORCRB, Oxford, OX3 7DQ, UK
| | - Hugh Kingston
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK
| | | | - Peter J M Openshaw
- National Heart and Lung Institute, Imperial College London, Chelsea, London, SW3 6LY, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK; Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Myra O McClure
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Richard S Tedder
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
| |
Collapse
|
5
|
Khan M, Rosadas C, Katsanovskaja K, Weber ID, Shute J, Ijaz S, Marchesin F, McClure E, Elias S, Flower B, Gao H, Quinlan R, Short C, Rosa A, Roustan C, Moshe M, Taylor GP, Elliott P, Cooke GS, Cherepanov P, Parker E, McClure MO, Tedder RS. Simple, sensitive, specific self-sampling assay secures SARS-CoV-2 antibody signals in sero-prevalence and post-vaccine studies. Sci Rep 2022; 12:1885. [PMID: 35115570 PMCID: PMC8814240 DOI: 10.1038/s41598-022-05640-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/17/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
At-home sampling is key to large scale seroprevalence studies. Dried blood spot (DBS) self-sampling removes the need for medical personnel for specimen collection but facilitates specimen referral to an appropriately accredited laboratory for accurate sample analysis. To establish a highly sensitive and specific antibody assay that would facilitate self-sampling for prevalence and vaccine-response studies. Paired sera and DBS eluates collected from 439 sero-positive, 382 sero-negative individuals and DBS from 34 vaccine recipients were assayed by capture ELISAs for IgG and IgM antibody to SARS-CoV-2. IgG and IgM combined on DBS eluates achieved a diagnostic sensitivity of 97.9% (95%CI 96.6 to 99.3) and a specificity of 99.2% (95% CI 98.4 to 100) compared to serum, displaying limits of detection equivalent to 23 and 10 WHO IU/ml, respectively. A strong correlation (r = 0.81) was observed between serum and DBS reactivities. Reactivity remained stable with samples deliberately rendered inadequate, (p = 0.234) and when samples were accidentally damaged or 'invalid'. All vaccine recipients were sero-positive. This assay provides a secure method for self-sampling by DBS with a sensitivity comparable to serum. The feasibility of DBS testing in sero-prevalence studies and in monitoring post-vaccine responses was confirmed, offering a robust and reliable tool for serological monitoring at a population level.
Collapse
Affiliation(s)
- Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Isaac D Weber
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Justin Shute
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Samreen Ijaz
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Eleanor McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Salem Elias
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Barnaby Flower
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - He Gao
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Charlotte Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Annachiara Rosa
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Chloe Roustan
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Maya Moshe
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Paul Elliott
- Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK.,Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, Imperial College London, Exhibition Rd, London, SW7 2AZ, UK
| | - Graham S Cooke
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Peter Cherepanov
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.
| |
Collapse
|
6
|
Claudiani S, Parker EL, Milojkovic D, Rosadas C, Khan A, Katsanovskaja K, Marchesin F, Khan M, Tedder RS, Innes AJ, McClure MO, Apperley JF. Long-term persistence of natural anti-SARS-CoV-2 antibodies and mild impact of SARS-CoV-2 infection in CML patients: results from a seroprevalence study. Leuk Lymphoma 2022; 63:1504-1507. [PMID: 35068289 DOI: 10.1080/10428194.2022.2027403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Simone Claudiani
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Haematology, Hammersmith Campus, Imperial College London, London, UK
| | - Eleanor L Parker
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Dragana Milojkovic
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Haematology, Hammersmith Campus, Imperial College London, London, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Afzal Khan
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Haematology, Hammersmith Campus, Imperial College London, London, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Andrew J Innes
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Haematology, Hammersmith Campus, Imperial College London, London, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, St Mary's Campus, Imperial College London, London, UK
| | - Jane F Apperley
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Haematology, Hammersmith Campus, Imperial College London, London, UK
| |
Collapse
|
7
|
Abbas A, Abdukahil SA, Abdulkadir NN, Abe R, Abel L, Absil L, Acharya S, Acker A, Adachi S, Adam E, Adrião D, Ageel SA, Ahmed S, Ain Q, Ainscough K, Aisa T, Ait Hssain A, Ait Tamlihat Y, Akimoto T, Akmal E, Al Qasim E, Alalqam R, Alam T, Al-dabbous T, Alegesan S, Alegre C, Alessi M, Alex B, Alexandre K, Al-Fares A, Alfoudri H, Ali I, Ali Shah N, Alidjnou KE, Aliudin J, Alkhafajee Q, Allavena C, Allou N, Altaf A, Alves J, Alves JM, Alves R, Amaral M, Amira N, Ammerlaan H, Ampaw P, Andini R, Andrejak C, Angheben A, Angoulvant F, Ansart S, Anthonidass S, Antonelli M, Antunes de Brito CA, Anwar KR, Apriyana A, Arabi Y, Aragao I, Arali R, Arancibia F, Araujo C, Arcadipane A, Archambault P, Arenz L, Arlet JB, Arnold-Day C, Aroca A, Arora L, Arora R, Artaud-Macari E, Aryal D, Asaki M, Asensio A, Ashley E, Ashraf M, Ashraf S, Asim M, Assie JB, Asyraf A, Atique A, Attanyake AMUL, Auchabie J, Aumaitre H, Auvet A, Azemar L, Azoulay C, Bach B, Bachelet D, Badr C, Baig N, Baillie JK, Baird JK, Bak E, Bakakos A, Bakar NA, Bal A, Balakrishnan M, Balan V, Bani-Sadr F, Barbalho R, Barbosa NY, Barclay WS, Barnett SU, Barnikel M, Barrasa H, Barrelet A, Barrigoto C, Bartoli M, Bartone C, Baruch J, Bashir M, Basmaci R, Basri MFH, Bastos D, Battaglini D, Bauer J, Bautista Rincon DF, Bazan Dow D, Bedossa A, Bee KH, Behilill S, Beishuizen A, Beljantsev A, Bellemare D, Beltrame A, Beltrão BA, Beluze M, Benech N, Benjiman LE, Benkerrou D, Bennett S, Bento L, Berdal JE, Bergeaud D, Bergin H, Bernal Sobrino JL, Bertoli G, Bertolino L, Bessis S, Betz A, Bevilcaqua S, Bezulier K, Bhatt A, Bhavsar K, Bianchi I, Bianco C, Bidin FN, Bikram Singh M, Bin Humaid F, Bin Kamarudin MN, Bissuel F, Biston P, Bitker L, Blanco-Schweizer P, Blier C, Bloos F, Blot M, Blumberg L, Boccia F, Bodenes L, Bogaarts A, Bogaert D, Boivin AH, Bolze PA, Bompart F, Bonfasius A, Borges D, Borie R, Bosse HM, Botelho-Nevers E, Bouadma L, Bouchaud O, Bouchez S, Bouhmani D, Bouhour D, Bouiller K, Bouillet L, Bouisse C, Boureau AS, Bourke J, Bouscambert M, Bousquet A, Bouziotis J, Boxma B, Boyer-Besseyre M, Boylan M, Bozza FA, Brack M, Braconnier A, Braga C, Brandenburger T, Brás Monteiro F, Brazzi L, Breen D, Breen P, Breen P, Brett S, Brickell K, Broadley T, Browne A, Browne S, Brozzi N, Brusse-Keizer M, Buchtele N, Buesaquillo C, Bugaeva P, Buisson M, Burhan E, Burrell A, Bustos IG, Butnaru D, Cabie A, Cabral S, Caceres E, Cadoz C, Callahan M, Calligy K, Calvache JA, Cam J, Campana V, Campbell P, Campisi J, Canepa C, Cantero M, Caraux-Paz P, Cárcel S, Cardellino CS, Cardoso F, Cardoso F, Cardoso N, Cardoso S, Carelli S, Carlier N, Carmoi T, Carney G, Carpenter C, Carqueja I, Carret MC, Carrier FM, Carroll I, Carson G, Carton E, Casanova ML, Cascão M, Casey S, Casimiro J, Cassandra B, Castañeda S, Castanheira N, Castor-Alexandre G, Castrillón H, Castro I, Catarino A, Catherine FX, Cattaneo P, Cavalin R, Cavalli GG, Cavayas A, Ceccato A, Cervantes-Gonzalez M, Chair A, Chakveatze C, Chan A, Chand M, Chantalat Auger C, Chapplain JM, Chas J, Chaudary M, Chávez Iñiguez JS, Chen A, Chen YS, Cheng MP, Cheret A, Chiarabini T, Chica J, Chidambaram SK, Chin-Tho L, Chirouze C, Chiumello D, Cho HJ, Cho SM, Cholley B, Chopin MC, Chow TS, Chow YP, Chua HJ, Chua J, Cidade JP, Cisneros Herreros JM, Citarella BW, Ciullo A, Clarke E, Clarke J, Claure Del Granado R, Clohisey S, Cobb JP, Coca N, Codan C, Cody C, Coelho A, Coles M, Colin G, Collins M, Colombo SM, Combs P, Connolly J, Connor M, Conrad A, Contreras S, Conway E, Cooke GS, Copland M, Cordel H, Corley A, Cormican S, Cornelis S, Cornet AD, Corpuz AJ, Cortegiani A, Corvaisier G, Costigan E, Couffignal C, Couffin-Cadiergues S, Courtois R, Cousse S, Cregan R, Crepy D'Orleans C, Croonen S, Crowl G, Crump J, Cruz C, Cruz Berm JL, Cruz Rojo J, Csete M, Cucino A, Cullen A, Cullen C, Cummings M, Curley G, Curlier E, Curran C, Custodio P, da Silva Filipe A, Da Silveira C, Dabaliz AA, Dagens A, Dahly D, Dalton H, Dalton J, Daly S, D'Amico F, Daneman N, Daniel C, Dankwa EA, Dantas J, D’Aragon F, de Boer M, de Loughry G, de Mendoza D, De Montmollin E, de Oliveira França RF, de Pinho Oliveira AI, De Rosa R, de Silva T, de Vries P, Deacon J, Dean D, Debard A, DeBenedictis B, Debray MP, DeCastro N, Dechert W, Deconninck L, Decours R, Defous E, Delacroix I, Delaveuve E, Delavigne K, Delfos NM, Deligiannis I, Dell'Amore A, Delmas C, Delobel P, Delsing C, Demonchy E, Denis E, Deplanque D, Depuydt P, Desai M, Descamps D, Desvallée M, Dewayanti S, Diallo A, Diamantis S, Dias A, Diaz P, Diaz R, Diaz Diaz JJ, Didier K, Diehl JL, Dieperink W, Dimet J, Dinot V, Diop F, Diouf A, Dishon Y, Dixit D, Djossou F, Docherty AB, Doherty H, Dondorp AM, Dong A, Donnelly CA, Donnelly M, Donohue C, Donohue S, Donohue Y, Doran C, Doran P, Dorival C, D'Ortenzio E, Douglas JJ, Douma R, Dournon N, Downer T, Downey J, Downing M, Drake T, Driscoll A, Dryden M, Duarte Fonseca C, Dubee V, Dubos F, Ducancelle A, Duculan T, Dudman S, Duggal A, Dunand P, Dunning J, Duplaix M, Durante-Mangoni E, Durham III L, Dussol B, Duthoit J, Duval X, Dyrhol-Riise AM, Ean SC, Echeverria-Villalobos M, Egan S, Eira C, El Sanharawi M, Elapavaluru S, Elharrar B, Ellerbroek J, Eloy P, Elshazly T, Elyazar I, Enderle I, Endo T, Eng CC, Engelmann I, Enouf V, Epaulard O, Escher M, Esperatti M, Esperou H, Esposito-Farese M, Estevão J, Etienne M, Ettalhaoui N, Everding AG, Evers M, Fabre I, Fabre M, Faheem A, Fahy A, Fairfield CJ, Fakar Z, Faria P, Farooq A, Farrar JJ, Farshait N, Fateena H, Fatoni AZ, Faure K, Favory R, Fayed M, Feely N, Feeney L, Fernandes J, Fernandes M, Fernandes S, Ferrand FX, Ferrand Devouge E, Ferrão J, Ferraz M, Ferreira B, Ferreira S, Ferrer-Roca R, Ferriere N, Ficko C, Figueiredo-Mello C, Fiorda J, Flament T, Flateau C, Fletcher T, Florio LL, Flynn B, Flynn D, Foley C, Foley J, Fomin V, Fonseca T, Fontela P, Forsyth S, Foster D, Foti G, Fourn E, Fowler RA, Fraher DM, Franch-Llasat D, Fraser C, Fraser JF, Freire MV, Freitas Ribeiro A, Friedrich C, Fritz R, Fry S, Fuentes N, Fukuda M, Gaborieau V, Gaci R, Gagliardi M, Gagnard JC, Gagné N, Gagneux-Brunon A, Gaião S, Gail Skeie L, Gallagher P, Gallego Curto E, Gamble C, Gani Y, Garan A, Garcia R, García Barrio N, Garcia-Diaz J, Garcia-Gallo E, Garimella N, Garot D, Garrait V, Gauli B, Gault N, Gavin A, Gavrylov A, Gaymard A, Gebauer J, Geraud E, Gerbaud Morlaes L, Germano N, ghisulal PK, Ghosn J, Giani M, Giaquinto C, Gibson J, Gigante T, Gilg M, Gilroy E, Giordano G, Girvan M, Gissot V, Gitahi J, Giwangkancana G, Glikman D, Glybochko P, Gnall E, Goco G, Goehringer F, Goepel S, Goffard JC, Goh JY, Golob J, Gomes R, Gomez K, Gómez-Junyent J, Gominet M, Gonzalez A, Gordon P, Gordon A, Gorenne I, Goubert L, Goujard C, Goulenok T, Grable M, Graf J, Grandin EW, Granier P, Grasselli G, Grazioli L, Green CA, Greene C, Greenhalf W, Greffe S, Grieco DL, Griffee M, Griffiths F, Grigoras I, Groenendijk A, Grosse Lordemann A, Gruner H, Gu Y, Guarracino F, Guedj J, Guego M, Guellec D, Guerguerian AM, Guerreiro D, Guery R, Guillaumot A, Guilleminault L, Guimarães de Castro M, Guimard T, Haalboom M, Haber D, Habraken H, Hachemi A, Hadri N, Haidash O, Haider S, Haidri F, Hakak S, Hall A, Hall M, Halpin S, Hamer A, Hamers R, Hamidfar R, Hammond T, Han LY, Haniffa R, Hao KW, Hardwick H, Harrison EM, Harrison J, Harrison SBE, Hartman A, Hashmi J, Hashmi M, Hayat M, Hayes A, Hays L, Heerman J, Heggelund L, Hendry R, Hennessy M, Henriquez A, Hentzien M, Herekar F, Hernandez-Montfort J, Herr D, Hershey A, Hesstvedt L, Hidayah A, Higgins D, Higgins E, HigginsOKeeffe G, Hinchion R, Hinton S, Hiraiwa H, Hitoto H, Ho A, Ho YB, Hoctin A, Hoffmann I, Hoh WH, Hoiting O, Holt R, Holter JC, Horby P, Horcajada JP, Hoshino K, Hoshino K, Houas I, Hough CL, Houltham S, Hsu JMY, Hulot JS, Hussain I, Ijaz S, Illes HG, Imbert P, Imran M, Imran Sikander R, Inácio H, Infante Dominguez C, Ing YS, Iosifidis E, Ippolito M, Isgett S, Ishani PGPI, Isidoro T, Ismail N, Isnard M, Itai J, Ito A, Ivulich D, Jaafar D, Jaafoura S, Jabot J, Jackson C, Jamieson N, Jaquet P, Jassat W, Jaud-Fischer C, Jaureguiberry S, Javidfar J, Jawad I, Jaworsky D, Jayakumar D, Jego F, Jelani AM, Jenum S, Jimbo-Sotomayor R, Job VDP, Joe OY, Jorge García RN, Joseph C, Joseph M, Joshi S, Jourdain M, Jouvet P, June J, Jung A, Jung H, Juzar D, Kafif O, Kaguelidou F, Kaisbain N, Kaleesvran T, Kali S, Kalicinska A, Kalomoiri S, Kamal S, Kamaluddin MAA, Kamaruddin ZAC, Kamarudin N, Kandamby DH, Kandel C, Kang KY, Kant R, Kanwal D, Kanyawati D, Karki B, Karpayah P, Karsies T, Kartsonaki C, Kasugai D, Kataria A, Katz K, Kaur A, Kaur Johal S, Kawasaki T, Kay C, Keane H, Keating S, Kellam P, Kelly A, Kelly A, Kelly C, Kelly N, Kelly S, Kelly Y, Kelsey M, Kennedy R, Kennon K, Kernan M, Kerroumi Y, Keshav S, Kestelyn E, Khalid I, Khalid O, Khalil A, Khan C, Khan I, Khanal S, Kho ME, Khoo D, Khoo R, Khoo S, Khoso N, Kiat KH, Kida Y, Kiiza P, Kildal AB, Kim JB, Kimmoun A, Kindgen-Milles D, King A, Kitamura N, Klenerman P, Klont R, Kloumann Bekken G, Knight S, Kobbe R, Kodippily C, Kohns Vasconcelos M, Koirala S, Komatsu M, Korten V, Kosgei C, Kpangon A, Krawczyk K, Krishnan S, Krishnan V, Kruglova O, Kumar A, Kumar D, Kumar G, Kumar M, Kumar Vecham P, Kuriakose D, Kurtzman E, Kusumastuti NP, Kutsogiannis D, Kutsyna G, Kyriakoulis K, Lachatre M, Lacoste M, Laffey JG, Lagrange M, Laine F, Lairez O, Lakhey S, Lalueza A, Lambert M, Lamontagne F, Langelot-Richard M, Langlois V, Lantang EY, Lanza M, Laouénan C, Laribi S, Lariviere D, Lasry S, Latif N, Launay O, Laureillard D, Lavie-Badie Y, Law A, Lawrence C, Lawrence T, Le M, Le Bihan C, Le Bris C, Le Falher G, Le Fevre L, Le Hingrat Q, Le Maréchal M, Le Mestre S, Le Moal G, Le Moing V, Le Nagard H, Le Turnier P, Leal E, Leal Santos M, Lee BH, Lee HG, Lee J, Lee SH, Lee TC, Lee YL, Leeming G, Lefebvre B, Lefebvre L, Lefevre B, LeGac S, Lelievre JD, Lellouche F, Lemaignen A, Lemee V, Lemeur A, Lemmink G, Lene HS, Lennon J, León R, Leone M, Leone M, Lepiller Q, Lescure FX, Lesens O, Lesouhaitier M, Lester-Grant A, Levy B, Levy Y, Levy-Marchal C, Lewandowska K, L'Her E, Li Bassi G, Liang J, Liaquat A, Liegeon G, Lim KC, Lim WS, Lima C, Lina B, Lina L, Lind A, Lingas G, Lion-Daolio S, Lissauer S, Liu K, Livrozet M, Lizotte P, Loforte A, Lolong N, Loon LC, Lopes D, Lopez-Colon D, Loschner AL, Loubet P, Loufti B, Louis G, Lourenco S, Lovelace-Macon L, Low LL, Lowik M, Loy JS, Lucet JC, Lumbreras Bermejo C, Luna CM, Lungu O, Luong L, Luque N, Luton D, Lwin N, Lyons R, Maasikas O, Mabiala O, MacDonald S, MacDonald S, Machado M, Macheda G, Macias Sanchez J, Madhok J, Maestro de la Calle G, Mahieu R, Mahy S, Maia AR, Maier LS, Maillet M, Maitre T, Malfertheiner M, Malik N, Mallon P, Maltez F, Malvy D, Manda V, Mandei JM, Mandelbrot L, Manetta F, Mangal K, Mankikian J, Manning E, Manuel A, Maria Sant`Ana Malaque C, Marino D, Marino F, Markowicz S, Maroun Eid C, Marques A, Marquis C, Marsh B, Marsh L, Marshal M, Marshall J, Martelli CT, Martin DA, Martin E, Martin-Blondel G, Martinelli A, Martin-Loeches I, Martinot M, Martin-Quiros A, Martins A, Martins J, Martins N, Martins Rego C, Martucci G, Martynenko O, Marwali EM, Marzukie M, Masa Jimenez JF, Maslove D, Maslove D, Mason P, Mason S, Masood S, Masood S, Mat Nor B, Matan M, Mateus Fernandes H, Mathew M, Mathieu D, Mattei M, Matulevics R, Maulin L, Maxwell M, Maynar J, Mazzoni T, Mc Sweeney L, McAndrew L, McArthur C, McCarthy A, McCarthy A, McCloskey C, McConnochie R, McDermott S, McDonald SE, McElroy A, McElwee S, McEneany V, McEvoy N, McGeer A, McKay C, McKeown J, McLean KA, McNally P, McNicholas B, McPartlan E, Meaney E, Mear-Passard C, Mechlin M, Meher M, Mehkri O, Mele F, Melo L, Memon K, Mendes JJ, Menkiti O, Menon K, Mentré F, Mentzer AJ, Mercier E, Mercier N, Merckx A, Mergeay-Fabre M, Mergler B, Merson L, Mesquita A, Metwally O, Meybeck A, Meyer D, Meynert AM, Meysonnier V, Meziane A, Mezidi M, Michelagnoli G, Michelanglei C, Michelet I, Mihelis E, Mihnovit V, Miranda-Maldonado H, Misnan NA, Mohamed NNE, Mohamed TJ, Moin A, Molina D, Molinos E, Molloy B, Mone M, Monteiro A, Montes C, Montrucchio G, Moore S, Moore SC, Morales Cely L, Moro L, Morocho Tutillo DR, Morton B, Motherway C, Motos A, Mouquet H, Mouton Perrot C, Moyet J, Mudara C, Mufti AK, Muh NY, Muhamad D, Mullaert J, Muller F, Müller KE, Munblit D, Muneeb S, Munir N, Munshi L, Murphy A, Murphy A, Murphy L, Murris M, Murthy S, Musaab H, Muyandy G, Myrodia DM, N N, Nagpal D, Nagrebetsky A, Narasimhan M, Narayanan N, Nasim Khan R, Nazerali-Maitland A, Neant N, Neb H, Nekliudov NA, Nelwan E, Neto R, Neumann E, Neves B, Ng PY, Nghi A, Nguyen D, Ni Choileain O, Ni Leathlobhair N, Nichol A, Nitayavardhana P, Nonas S, Noordin NAM, Noret M, Norharizam NFI, Norman L, Notari A, Noursadeghi M, Nowicka K, Nowinski A, Nseir S, Nunez JI, Nurnaningsih N, Nyamankolly E, O Brien F, O'Callaghan A, Occhipinti G, OConnor D, O'Donnell M, Ogston T, Ogura T, Oh TH, O'Halloran S, O'Hearn K, Ohshimo S, Oldakowska A, Oliveira J, Oliveira L, Olliaro PL, O'Neil C, Ong DS, Ong JY, Oosthuyzen W, Opavsky A, Openshaw P, Orakzai S, Orozco-Chamorro CM, Orquera A, Ortoleva J, Osatnik J, O'Shea L, O'Sullivan M, Othman SZ, Ouamara N, Ouissa R, Owyang C, Oziol E, Pabasara HMU, Pagadoy M, Pages J, Palacios A, Palacios M, Palmarini M, Panarello G, Panda PK, Paneru H, Pang LH, Panigada M, Pansu N, Papadopoulos A, Parke R, Parker M, Parra B, Parrini V, Pasha T, Pasquier J, Pastene B, Patauner F, Patel J, Pathmanathan MD, Patrão L, Patricio P, Patrier J, Patterson L, Pattnaik R, Paul C, Paul M, Paulos J, Paxton WA, Payen JF, Peariasamy K, Pedrera Jiménez M, Peek GJ, Peelman F, Peiffer-Smadja N, Peigne V, Pejkovska M, Pelosi P, Peltan ID, Pereira R, Perez D, Periel L, Perpoint T, Pesenti A, Pestre V, Petrou L, Petrov-Sanchez V, Pettersen FO, Peytavin G, Pharand S, Piagnerelli M, Picard W, Picone O, Piero MD, Pierobon C, Piersma D, Pimentel C, Pinto R, Pires C, Pironneau I, Piroth L, Pius R, Piva S, Plantier L, Plotkin D, Png HS, Poissy J, Pokeerbux R, Pokorska-Spiewak M, Poli S, Pollakis G, Ponscarme D, Popielska J, Post AM, Postma DF, Povoa P, Póvoas D, Powis J, Prapa S, Preau S, Prebensen C, Preiser JC, Prinssen A, Pritchard MG, Priyadarshani GDD, Proença L, Pudota S, Puéchal O, Pujo Semedi B, Pulicken M, Puntoni M, Purcell G, Quesada L, Quinones-Cardona V, Quirós González V, Quist-Paulsen E, Quraishi M, Rabaa M, Rabaud C, Rabindrarajan E, Rafael A, Rafiq M, Ragazzo G, Rahman AKHA, Rahman RA, Rahutullah A, Rainieri F, Rajahram GS, Rajapakse N, Ralib A, Ramakrishnan N, Ramanathan K, Ramli AA, Rammaert B, Ramos GV, Rana A, Rangappa R, Ranjan R, Rapp C, Rashan A, Rashan T, Rasheed G, Rasmin M, Rätsep I, Rau C, Ravi T, Raza A, Real A, Rebaudet S, Redl S, Reeve B, Rehan A, Rehman A, Reid L, Reid L, Reikvam DH, Reis R, Rello J, Remppis J, Remy M, Ren H, Renk H, Resende L, Resseguier AS, Revest M, Rewa O, Reyes LF, Reyes T, Ribeiro MI, Richardson D, Richardson D, Richier L, Ridzuan SNAA, Riera J, Rios AL, Rishu A, Rispal P, Risso K, Rivera Nuñez MA, Rizer N, Robb D, Robba C, Roberto A, Roberts S, Robertson DL, Robineau O, Roche-Campo F, Rodari P, Rodeia S, Rodriguez Abreu J, Roessler B, Roger C, Roger PM, Roilides E, Rojek A, Romaru J, Roncon-Albuquerque Jr R, Roriz M, Rosa-Calatrava M, Rose M, Rosenberger D, Rossanese A, Rossetti M, Rossignol B, Rossignol P, Rousset S, Roy C, Roze B, Rusmawatiningtyas D, Russell CD, Ryan M, Ryan M, Ryckaert S, Rygh Holten A, Saba I, Sadaf S, Sadat M, Sahraei V, Saint-Gilles M, Sakiyalak P, Salahuddin N, Salazar L, Saleem J, Saleem J, Sales G, Sallaberry S, Salmon Gandonniere C, Salvator H, Sanchez O, Sánchez Choez X, Sanchez de Oliveira K, Sanchez-Miralles A, Sancho-Shimizu V, Sandhu G, Sandhu Z, Sandrine PF, Sandulescu O, Santos M, Sarfo-Mensah S, Sarmento Banheiro B, Sarmiento ICE, Sarton B, Satyapriya S, Satyawati R, Saviciute E, Savio R, Savvidou P, Saw YT, Schaffer J, Schermer T, Scherpereel A, Schneider M, Schroll S, Schwameis M, Schwartz G, Scott JT, Scott-Brown J, Sedillot N, Seitz T, Selvanayagam J, Selvarajoo M, Semaille C, Semple MG, Senian RB, Senneville E, Sepulveda C, Sequeira F, Sequeira T, Serpa Neto A, Serrano Balazote P, Shadowitz E, Shahidan SA, Shahnaz Hasan M, Shamsah M, Shankar A, Sharjeel S, Sharma P, Shaw CA, Shaw V, Shi H, Shiban N, Shiekh M, Shiga T, Shime N, Shimizu H, Shimizu K, Shimizu N, Shindo N, Shrapnel S, Shum HP, Si Mohammed N, Siang NY, Sibiude J, Siddiqui A, Sigfrid L, Sillaots P, Silva C, Silva MJ, Silva R, Sim Lim Heng B, Sin WC, Singh BC, Singh P, Sitompul PA, Sivam K, Skogen V, Smith S, Smood B, Smyth C, Smyth M, Smyth M, Snacken M, So D, Soh TV, Solis M, Solomon J, Solomon T, Somers E, Sommet A, Song MJ, Song R, Song T, Song Chia J, Sonntagbauer M, Soom AM, Sotto A, Soum E, Sousa AC, Sousa M, Sousa Uva M, Souza-Dantas V, Sperry A, Spinuzza E, Sri Darshana BPSR, Sriskandan S, Stabler S, Staudinger T, Stecher SS, Steinsvik T, Stienstra Y, Stiksrud B, Stolz E, Stone A, Streinu-Cercel A, Streinu-Cercel A, Strudwick S, Stuart A, Stuart D, Subekti D, Suen G, Suen JY, Sukumar P, Sultana A, Summers C, Supic D, Suppiah D, Surovcová M, Suwarti S, Svistunov AA, Syahrin S, Syrigos K, Sztajnbok J, Szuldrzynski K, Tabrizi S, Taccone FS, Tagherset L, Taib SM, Talarek E, Taleb S, Talsma J, Tampubolon ML, Tan KK, Tan LV, Tan YC, Tanaka C, Tanaka H, Tanaka T, Taniguchi H, Tanveer H, Taqdees H, Taqi A, Tardivon C, Tattevin P, Taufik MA, Tawfik H, Tedder RS, Tee TY, Teixeira J, Tejada S, Tellier MC, Teoh SK, Teotonio V, Téoulé F, Terpstra P, Terrier O, Terzi N, Tessier-Grenier H, Tey A, Thabit AAM, Tham ZD, Thangavelu S, Thibault V, Thiberville SD, Thill B, Thirumanickam J, Thompson S, Thomson D, Thomson EC, Thurai SRT, Thuy DB, Thwaites RS, Tierney P, Tieroshyn V, Timashev PS, Timsit JF, Tirupakuzhi Vijayaraghavan BK, Tissot N, Toh JZY, Toki M, Tolppa T, Tonby K, Tonnii SL, Torres A, Torres M, Torres Santos-Olmo RM, Torres-Zevallos H, Towers M, Trapani T, Traynor D, Treoux T, Trieu HT, Tripathy S, Tromeur C, Trontzas I, Trouillon T, Truong J, Tual C, Tubiana S, Tuite H, Turmel JM, Turtle LC, Tveita A, Twardowski P, Uchiyama M, Udayanga PGI, Udy A, Ullrich R, Umer Z, Uribe A, Usman A, Vajdovics C, Val-Flores L, Valle AL, Valran A, Van de Velde S, van den Berge M, van der Feltz M, van der Valk P, Van Der Vekens N, Van der Voort P, Van Der Werf S, van Dyk M, van Gulik L, Van Hattem J, van Lelyveld S, van Netten C, Van Twillert G, van Veen I, Vanel N, Vanoverschelde H, Varghese P, Varrone M, Vasudayan SR, Vauchy C, Vaughan H, Veeran S, Veislinger A, Vencken S, Ventura S, Verbon A, Vidal JE, Vieira C, Vijayan D, Villanueva JA, Villar J, Villeneuve PM, Villoldo A, Vinh Chau NV, Visseaux B, Visser H, Vitiello C, Vonkeman H, Vuotto F, Wahab NH, Wahab SA, Wahid NA, Wainstein M, Wan Muhd Shukeri WF, Wang CH, Webb SA, Wei J, Weil K, Wen TP, Wesselius S, West TE, Wham M, Whelan B, White N, Wicky PH, Wiedemann A, Wijaya SO, Wille K, Willems S, Williams V, Wils EJ, Wing Yiu N, Wong C, Wong TF, Wong XC, Wong YS, Xian GE, Xian LS, Xuan KP, Xynogalas I, Yacoub S, Yakop SRBM, Yamazaki M, Yazdanpanah Y, Yee Liang Hing N, Yelnik C, Yeoh CH, Yerkovich S, Yokoyama T, Yonis H, Yousif O, Yuliarto S, Zaaqoq A, Zabbe M, Zacharowski K, Zahid M, Zahran M, Zaidan NZB, Zambon M, Zambrano M, Zanella A, Zawadka K, Zaynah N, Zayyad H, Zoufaly A, Zucman D. The value of open-source clinical science in pandemic response: lessons from ISARIC. Lancet Infect Dis 2021; 21:1623-1624. [PMID: 34619109 PMCID: PMC8489876 DOI: 10.1016/s1473-3099(21)00565-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/16/2021] [Indexed: 12/31/2022]
|
8
|
Ijaz S, Derrick J, Shute J, Ireland G, Hayden I, Ngui SL, Mandal S, Tedder RS. Mother To Infant Transmission Of Hepatitis B Virus In The Face Of Neonatal Immunisation Is Not Necessarily Primary Vaccine Failure. Clin Infect Dis 2021; 74:1151-1157. [PMID: 34251456 DOI: 10.1093/cid/ciab622] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Surveillance programmes undertaken in infants born to hepatitis B virus (HBV) infected mothers provide an opportunity to analyse virological markers from the neonate and early infancy. These data inform on mechanisms of HBV transmission and how available interventions can be better utilised for control of HBV infections arising at the mother/child interface. METHODS Retrospective analysis of HBV serological markers was undertaken in Dried Blood Spots collected from infants born to HBV-infected mothers. In addition, molecular analysis was performed in newborn blood spot cards, collected after birth, from infants identified as HBV-infected despite receiving prophylaxis. RESULTS Perinatal exposure could not account for all transmissions with at least one quarter (22%) of infants already infected in utero. All harboured a wild type HBsAg, with identical sequences noted in the neonatal and early infancy samples. In contrast, in infants infected perinatally (43%), selection of viruses harbouring amino acid changes in the HBsAg were common (80% of sequences) and divergent from the linked maternal sample. CONCLUSION Currently considered to represent vaccine failure, it is likely that a proportion of HBV infections result from in utero acquisition. These infections are unlikely to be susceptible to post-natal prophylaxis and current recommendations for maternal antiviral treatment may be too late to prevent transmission. Consideration should be given to the earlier use of antivirals during gestation to reduce the risk of intrauterine transmission together with completion of the immunisation schedule also to reduce the perinatal risk of HBV transmission.
Collapse
Affiliation(s)
- Samreen Ijaz
- Blood Borne Virus Unit, National Infection Service, Public Health England, London, UK.,Blood Safety, Hepatitis, STI and HIV Division, National Infection Service, Public Health England, London, UK
| | - Jade Derrick
- Blood Borne Virus Unit, National Infection Service, Public Health England, London, UK
| | - Justin Shute
- Blood Borne Virus Unit, National Infection Service, Public Health England, London, UK
| | - Georgina Ireland
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service, Public Health England, London, UK
| | - Iain Hayden
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Siew Lin Ngui
- Blood Borne Virus Unit, National Infection Service, Public Health England, London, UK
| | - Sema Mandal
- Blood Safety, Hepatitis, STI and HIV Division, National Infection Service, Public Health England, London, UK.,Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, National Infection Service, Public Health England, London, UK.,Microbiology Services, NHS Blood and Transplant, London, UK.,University College London, London, UK
| |
Collapse
|
9
|
Pereira C, Harris BHL, Di Giovannantonio M, Rosadas C, Short CE, Quinlan R, Sureda-Vives M, Fernandez N, Day-Weber I, Khan M, Marchesin F, Katsanovskaja K, Parker E, Taylor GP, Tedder RS, McClure MO, Dani M, Fertleman M. The Association Between Antibody Response to Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Post-COVID-19 Syndrome in Healthcare Workers. J Infect Dis 2021; 223:1671-1676. [PMID: 33675366 PMCID: PMC7989400 DOI: 10.1093/infdis/jiab120] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/27/2020] [Accepted: 02/26/2021] [Indexed: 12/19/2022] Open
Abstract
It is currently unknown how post-COVID-19 syndrome (PCS) may affect those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This longitudinal study includes healthcare staff who tested positive for SARS-CoV-2 between March and April 2020, with follow-up of their antibody titers and symptoms. More than half (21 of 38) had PCS after 7–8 months. There was no statistically significant difference between initial reverse-transcription polymerase chain reaction titers or serial antibody levels between those who did and those who did not develop PCS. This study highlights the relative commonality of PCS in healthcare workers and this should be considered in vaccination scheduling and workforce planning to allow adequate frontline staffing numbers.
Collapse
Affiliation(s)
- Christopher Pereira
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom.,The Wellington Hospital, Circus Road, St John's Wood, London, United Kingdom
| | - Benjamin H L Harris
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom.,The Wellington Hospital, Circus Road, St John's Wood, London, United Kingdom
| | - Matteo Di Giovannantonio
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Charlotte-Eve Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Macià Sureda-Vives
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Natalia Fernandez
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Isaac Day-Weber
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Melanie Dani
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom.,Department of Geriatric Medicine, Hammersmith Hospital, London, United Kingdom
| | - Michael Fertleman
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom
| |
Collapse
|
10
|
Rosa A, Pye VE, Graham C, Muir L, Seow J, Ng KW, Cook NJ, Rees-Spear C, Parker E, Dos Santos MS, Rosadas C, Susana A, Rhys H, Nans A, Masino L, Roustan C, Christodoulou E, Ulferts R, Wrobel AG, Short CE, Fertleman M, Sanders RW, Heaney J, Spyer M, Kjær S, Riddell A, Malim MH, Beale R, MacRae JI, Taylor GP, Nastouli E, van Gils MJ, Rosenthal PB, Pizzato M, McClure MO, Tedder RS, Kassiotis G, McCoy LE, Doores KJ, Cherepanov P. SARS-CoV-2 can recruit a heme metabolite to evade antibody immunity. Sci Adv 2021; 7:eabg7607. [PMID: 33888467 PMCID: PMC8163077 DOI: 10.1126/sciadv.abg7607] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/02/2021] [Indexed: 05/11/2023]
Abstract
The coronaviral spike is the dominant viral antigen and the target of neutralizing antibodies. We show that SARS-CoV-2 spike binds biliverdin and bilirubin, the tetrapyrrole products of heme metabolism, with nanomolar affinity. Using cryo-electron microscopy and x-ray crystallography, we mapped the tetrapyrrole interaction pocket to a deep cleft on the spike N-terminal domain (NTD). At physiological concentrations, biliverdin significantly dampened the reactivity of SARS-CoV-2 spike with immune sera and inhibited a subset of neutralizing antibodies. Access to the tetrapyrrole-sensitive epitope is gated by a flexible loop on the distal face of the NTD. Accompanied by profound conformational changes in the NTD, antibody binding requires relocation of the gating loop, which folds into the cleft vacated by the metabolite. Our results indicate that SARS-CoV-2 spike NTD harbors a dominant epitope, access to which can be controlled by an allosteric mechanism that is regulated through recruitment of a metabolite.
Collapse
Affiliation(s)
- Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Valerie E Pye
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Luke Muir
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Kevin W Ng
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
| | - Nicola J Cook
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Chloe Rees-Spear
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Eleanor Parker
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | | | - Carolina Rosadas
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Alberto Susana
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Hefin Rhys
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Andrea Nans
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Laura Masino
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | | | - Rachel Ulferts
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - Antoni G Wrobel
- Structural Biology of Disease Processes Laboratory, The Francis Crick Institute, London, UK
| | - Charlotte-Eve Short
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Michael Fertleman
- Cutrale Perioperative and Ageing Group, Imperial College London, London, UK
| | - Rogier W Sanders
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
- Weill Medical College of Cornell University, New York, NY, USA
| | - Judith Heaney
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
| | - Moira Spyer
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Svend Kjær
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Andy Riddell
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Rupert Beale
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - James I MacRae
- Metabolomics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Eleni Nastouli
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Marit J van Gils
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
| | - Peter B Rosenthal
- Structural Biology of Cells and Viruses Laboratory, The Francis Crick Institute, London, UK
| | - Massimo Pizzato
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Myra O McClure
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Richard S Tedder
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - George Kassiotis
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK.
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Laura E McCoy
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK.
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK.
| | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK.
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| |
Collapse
|
11
|
Harris BHL, Zuhair M, Di Giovannantonio M, Rosadas C, Khan M, Short CE, Thaventhiran T, Quinlan R, Taylor A, Calvez R, Taylor GP, Tedder RS, McClure MO, Fertleman M. Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in a Rehabilitation Facility: Evolution of the Presence of Nasopharyngeal SARS-CoV-2 and Serological Antibody Responses. J Infect Dis 2021; 223:192-196. [PMID: 33535238 PMCID: PMC7665566 DOI: 10.1093/infdis/jiaa610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/25/2020] [Indexed: 01/02/2023] Open
Abstract
At the start of the UK coronavirus disease 2019 epidemic, this rare point prevalence study revealed that one-third of patients (15 of 45) in a London inpatient rehabilitation unit were found to be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) but asymptomatic. We report on 8 patients in detail, including their clinical stability, the evolution of their nasopharyngeal viral reverse-transcription polymerase chain reaction (RT-PCR) burden, and their antibody levels over time, revealing the infection dynamics by RT-PCR and serology during the acute phase. Notably, a novel serological test for antibodies against the receptor binding domain of SARS-CoV-2 showed that 100% of our asymptomatic cohort remained seropositive 3-6 weeks after diagnosis.
Collapse
Affiliation(s)
- Benjamin H L Harris
- The Wellington Hospital, Circus Road, St John’s Wood, London, United Kingdom
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Mohamed Zuhair
- The Wellington Hospital, Circus Road, St John’s Wood, London, United Kingdom
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Matteo Di Giovannantonio
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Charlotte-Eve Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Thilipan Thaventhiran
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Andrew Taylor
- Micropathology, University of Warwick Science Park, Coventry, United Kingdom
| | - Ronan Calvez
- Micropathology, University of Warwick Science Park, Coventry, United Kingdom
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Michael Fertleman
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom
| |
Collapse
|
12
|
Affiliation(s)
- Richard S Tedder
- Department of Infectious Disease, Imperial College London, London W21PG, UK.
| | - Malcolm G Semple
- Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool, UK
| |
Collapse
|
13
|
Ankcorn M, Said B, Morgan D, Elsharkawy AM, Maggs J, Ryder S, Valliani T, Gordon F, Abeysekera K, Suri D, McPherson S, Galliford J, Smith B, Pelosi E, Bansal S, Bethune C, Sheridan D, Vine L, Tedder RS, Ijaz S, Zuckerman M, Dalton H, Healy B, Donati M, Bicknell K, Evans C, Poller B, Smit E, Halsema C, Williams E, Raza M, McGann H, Irving W, Douthwaite S, Ch'ng CL, McCaughey C, Irish D. Persistent Hepatitis E virus infection across England and Wales 2009-2017: Demography, virology and outcomes. J Viral Hepat 2021; 28:420-430. [PMID: 33073452 DOI: 10.1111/jvh.13424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/20/2020] [Accepted: 10/02/2020] [Indexed: 01/11/2023]
Abstract
The first clinical case of persistent HEV infection in England was reported in 2009. We describe the demography, virology and outcomes of patients identified with persistent HEV infection in England and Wales between 2009 and 2017. A series of 94 patients with persistent HEV infection, defined by HEV viraemia of more than 12 weeks, was identified through routine reference laboratory testing. Virology, serology and clinical data were recorded through an approved PHE Enhanced Surveillance System. Sixty-six cases (70.2%) were transplant recipients, 16 (17.0%) had an underlying haematological malignancy without stem cell transplantation, six (6.4%) had advanced HIV infection, five (5.3%) were otherwise immunosuppressed, and one patient (1.1%) had no identified immunosuppression. Retrospective analysis of 46 patients demonstrated a median 38 weeks of viraemia before diagnostic HEV testing. At initial diagnosis, 16 patients (17.0%) had no detectable anti-HEV serological response. Of 65 patients treated with ribavirin monotherapy, 11 (16.9%) suffered virological relapse despite undetectable RNA in plasma or stool at treatment cessation. Persistent HEV infection remains a rare diagnosis, but we demonstrate that a broad range of immunocompromised patients are susceptible. Both lack of awareness and the pauci-symptomatic nature of persistent HEV infection likely contribute to significant delays in diagnosis. Diagnosis should rely on molecular testing since anti-HEV serology is insufficient to exclude persistent HEV infection. Finally, despite treatment with ribavirin, relapses occur even after cessation of detectable faecal shedding of HEV RNA, further emphasising the requirement to demonstrate sustained virological responses to treatment.
Collapse
Affiliation(s)
- Michael Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Bengü Said
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London, UK
| | - Dilys Morgan
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London, UK
| | | | - James Maggs
- Department of Gastroenterology, Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK
| | - Stephen Ryder
- Department of Hepatology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Talal Valliani
- North Bristol Liver Unit, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Fiona Gordon
- Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Kushala Abeysekera
- Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Deepak Suri
- Department of Hepatology, University College London Hospitals, London, UK
| | - Stuart McPherson
- Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, & Institute of Cellular Medicine, Newcastle University, Newcastle, UK
| | - Jack Galliford
- Department of Nephrology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Belinda Smith
- Department of Hepatology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Emanuela Pelosi
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sanjay Bansal
- Department of Paediatric Hepatology, Gastroenterology & Nutrition Center, King's College Hospital NHS Foundation Trust, London, UK
| | - Claire Bethune
- Department of Immunology and Allergy, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - David Sheridan
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Louisa Vine
- South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK.,Department of Medicine, Imperial College London, London, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Motedayen Aval L, Boullier M, Lyall H, Collins GP, Ayto R, Kelly DF, Tedder RS, Drysdale SB, Taylor GP, Cook LB. Adult T cell leukaemia/lymphoma (ATL) in pregnancy: A UK case series. eJHaem 2021; 2:131-135. [PMID: 35846087 PMCID: PMC9175930 DOI: 10.1002/jha2.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 01/17/2023]
Abstract
Introduction Chronic infection with human T‐cell lymphotropic virus type‐1 (HTLV‐1) may result in aggressive adult T‐cell leukaemia/lymphoma (ATL) in 4‐6% carriers. The majority of this risk arises in carriers infected during infancy, and so each infant has ∼25% lifetime risk. Other risk factors include a family history of ATL. Antenatal HTLV‐1 screening is not undertaken in the UK. Methods Here we describe four cases of ATL diagnosed during pregnancy and describe strategies to minimise HTLV‐1 transmission to neonates. Results/conclusion These cases highlight undiagnosed HTLV‐1 in pregnancy which allows ongoing mother to child vertical transmission and risk of future ATL. We recommend the UK National Screening Committee incorporate HTLV‐1 serology into antenatal screening.
Collapse
Affiliation(s)
| | - Mary Boullier
- Department of PaediatricsSt George's University Hospitals NHS Foundation TrustLondonUK
| | - Hermione Lyall
- Department of Paediatric Infectious DiseasesImperial College Healthcare NHS TrustLondonUK
| | - Graham P. Collins
- Department of HaematologyOxford University Hospitals NHS Foundation TrustOxfordUK
| | - Robert Ayto
- Department of HaematologyPortsmouth Hospitals NHS TrustHampshireUK
| | - Dominic F. Kelly
- Oxford Vaccine GroupDepartment of PaediatricsUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreOxfordUK
| | | | - Simon B. Drysdale
- Department of PaediatricsSt George's University Hospitals NHS Foundation TrustLondonUK
- Oxford Vaccine GroupDepartment of PaediatricsUniversity of OxfordOxfordUK
| | - Graham P. Taylor
- Section of Virology, Imperial CollegeLondonUK
- National Centre for Human RetrovirologyImperial College Healthcare NHS TrustLondonUK
| | - Lucy B. Cook
- Section of Virology, Imperial CollegeLondonUK
- Centre for HaematologyImperial College Healthcare NHS TrustLondonUK
- National Centre for Human RetrovirologyImperial College Healthcare NHS TrustLondonUK
| |
Collapse
|
15
|
Davis CA, Haywood B, Vattipally S, Da Silva Filipe A, AlSaeed M, Smollet K, Baylis SA, Ijaz S, Tedder RS, Thomson EC, Abdelrahman TT. Hepatitis E virus: Whole genome sequencing as a new tool for understanding HEV epidemiology and phenotypes. J Clin Virol 2021; 139:104738. [PMID: 33933822 DOI: 10.1016/j.jcv.2021.104738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/05/2020] [Revised: 12/28/2020] [Accepted: 01/12/2021] [Indexed: 12/24/2022]
Abstract
Hepatitis E Virus (HEV) is emerging as a public health concern across Europe and tools for complete genome data to aid epidemiological and virulence analysis are needed. The high sequence heterogeneity observed amongst HEV genotypes has restricted most analyses to subgenomic regions using PCR-based methods, which can be unreliable due to poor primer homology. We designed a panel of custom-designed RNA probes complementary to all published HEV full genome NCBI sequences. A target enrichment protocol was performed according to the NimbleGen® standard protocol for Illumina® library preparation. Optimisation of this protocol was performed using 40 HEV RNA-positive serum samples and the World Health Organization International Reference Panel for Hepatitis E Virus RNA Genotypes for Nucleic Acid Amplification Technique (NAT)-Based Assays and related reference materials. Deep sequencing using this target enrichment protocol resulted in whole genome consensus sequences from samples with a viral load range of 1.25 × 104-1.17 × 107 IU/mL. Phylogenetic analysis of these sequences recapitulated and extended the partial genome results obtained from genotyping by Sanger sequencing (genotype 1, ten samples and genotype 3, 30 samples). The protocol is highly adaptable to automation and could be used to sequence full genomes of large sample numbers. A more comprehensive understanding of hepatitis E virus transmission, epidemiology and viral phenotype prediction supported by an efficient method of sequencing the whole viral genome will facilitate public health initiatives to reduce the prevalence and mitigate the harm of HEV infection in Europe.
Collapse
Affiliation(s)
| | - Becky Haywood
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | | | | | - Mariam AlSaeed
- Life Science & Environment Research Institute, National Center for Genome Technology, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | | | | | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK; University College London, London, UK; Microbiology Services, NHS Blood and Transplant, Colindale, UK
| | - Emma C Thomson
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Tamir T Abdelrahman
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK; Microbiology Department, Laboratoire National de Sante, Dudelange, Luxembourg.
| |
Collapse
|
16
|
Rosa A, Pye VE, Graham C, Muir L, Seow J, Ng KW, Cook NJ, Rees-Spear C, Parker E, dos Santos MS, Rosadas C, Susana A, Rhys H, Nans A, Masino L, Roustan C, Christodoulou E, Ulferts R, Wrobel A, Short CE, Fertleman M, Sanders RW, Heaney J, Spyer M, Kjær S, Riddell A, Malim MH, Beale R, MacRae JI, Taylor GP, Nastouli E, van Gils MJ, Rosenthal PB, Pizzato M, McClure MO, Tedder RS, Kassiotis G, McCoy LE, Doores KJ, Cherepanov P. SARS-CoV-2 recruits a haem metabolite to evade antibody immunity. medRxiv 2021:2021.01.21.21249203. [PMID: 33532784 PMCID: PMC7852234 DOI: 10.1101/2021.01.21.21249203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The coronaviral spike is the dominant viral antigen and the target of neutralizing antibodies. We show that SARS-CoV-2 spike binds biliverdin and bilirubin, the tetrapyrrole products of haem metabolism, with nanomolar affinity. Using cryo-electron microscopy and X-ray crystallography we mapped the tetrapyrrole interaction pocket to a deep cleft on the spike N-terminal domain (NTD). At physiological concentrations, biliverdin significantly dampened the reactivity of SARS-CoV-2 spike with immune sera and inhibited a subset of neutralizing antibodies. Access to the tetrapyrrole-sensitive epitope is gated by a flexible loop on the distal face of the NTD. Accompanied by profound conformational changes in the NTD, antibody binding requires relocation of the gating loop, which folds into the cleft vacated by the metabolite. Our results indicate that the virus co-opts the haem metabolite for the evasion of humoral immunity via allosteric shielding of a sensitive epitope and demonstrate the remarkable structural plasticity of the NTD.
Collapse
Affiliation(s)
- Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Valerie E. Pye
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, UK
| | - Luke Muir
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, UK
| | - Kevin W. Ng
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
| | - Nicola J. Cook
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Chloe Rees-Spear
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Eleanor Parker
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | | | - Carolina Rosadas
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | - Alberto Susana
- Department of Cellular, Computational and Integrative Biology, University of Trento, Italy
| | - Hefin Rhys
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Andrea Nans
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Laura Masino
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | | | - Rachel Ulferts
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - Antoni Wrobel
- Structural Biology of Disease Processes Laboratory, The Francis Crick Institute, London, UK
| | - Charlotte-Eve Short
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | | | - Rogier W. Sanders
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
- Weill Medical College of Cornell University, New York, US
| | - Judith Heaney
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
| | - Moira Spyer
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Svend Kjær
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Andy Riddell
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Michael H. Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, UK
| | - Rupert Beale
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - James I. MacRae
- Metabolomics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Graham P. Taylor
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | - Eleni Nastouli
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Marit J. van Gils
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
| | - Peter B. Rosenthal
- Structural Biology of Cells and Viruses Laboratory, The Francis Crick Institute, London, UK
| | - Massimo Pizzato
- Department of Cellular, Computational and Integrative Biology, University of Trento, Italy
| | - Myra O. McClure
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | - Richard S. Tedder
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | - George Kassiotis
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| | - Laura E. McCoy
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Katie J. Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King’s College London, UK
| | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
- Department of Infectious Disease, St-Mary’s Campus, Imperial College London, UK
| |
Collapse
|
17
|
Wells PM, Doores KJ, Couvreur S, Nunez RM, Seow J, Graham C, Acors S, Kouphou N, Neil SJD, Tedder RS, Matos PM, Poulton K, Lista MJ, Dickenson RE, Sertkaya H, Maguire TJA, Scourfield EJ, Bowyer RCE, Hart D, O'Byrne A, Steel KJA, Hemmings O, Rosadas C, McClure MO, Capedevilla-Pujol J, Wolf J, Ourselin S, Brown MA, Malim MH, Spector T, Steves CJ. Estimates of the rate of infection and asymptomatic COVID-19 disease in a population sample from SE England. J Infect 2020; 81:931-936. [PMID: 33068628 PMCID: PMC7557299 DOI: 10.1016/j.jinf.2020.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Understanding of the true asymptomatic rate of infection of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. METHODS We undertook enzyme linked immunosorbent assay characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged 19-86 (median age 48; 85% female). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. FINDINGS We demonstrated a seroprevalence of 12% (51 participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic, and 16 (27%) were asymptomatic for core COVID-19 symptoms: fever, cough or anosmia. Specificity of anosmia for seropositivity was 95%, compared to 88% for fever cough and anosmia combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. INTERPRETATION Seroprevalence amongst adults from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic throughout the study. Anosmia demonstrated the highest symptom specificity for SARS-CoV-2 antibody response. FUNDING NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC.
Collapse
Affiliation(s)
- Philippa M Wells
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Simon Couvreur
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Rocio Martinez Nunez
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Sam Acors
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Neophytos Kouphou
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Stuart J D Neil
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | | | - Pedro M Matos
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kate Poulton
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Maria Jose Lista
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth E Dickenson
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Helin Sertkaya
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Edward J Scourfield
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Ruth C E Bowyer
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Deborah Hart
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Aoife O'Byrne
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Kathryn J A Steel
- Centre for Inflammation Biology and Cancer Immunology, Department of Inflammation Biology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Oliver Hemmings
- Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - Myra O McClure
- Department of Infectious Disease, Imperial College London, UK
| | | | | | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Matthew A Brown
- Department of Medical & Molecular Genetics, Guy's and St Thomas' Hospital NHS Trust and King's College London NIHR Biomedical Research Centre, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Tim Spector
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK
| | - Claire J Steves
- Department of Twin Research, King's College London, St Thomas' Hospital, London SE1 7EH, UK.
| |
Collapse
|
18
|
Affiliation(s)
- Carolina Rosadas
- Department of Infectious Disease, Imperial College London, London, UK
| | - Paul Randell
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Maryam Khan
- Department of Infectious Disease, Imperial College London, London, UK
| | - Myra O McClure
- Department of Infectious Disease, Imperial College London, London, UK
| | - Richard S Tedder
- Department of Infectious Disease, Imperial College London, London, UK; Jefferiss Research Trust Laboratories, Wright-Fleming Institute, Faculty of Medicine, Imperial College London, London W2 1PG, UK.
| |
Collapse
|
19
|
Ankcorn MJ, Tedder RS, Cairns J, Sandmann FG. Cost-Effectiveness Analysis of Screening for Persistent Hepatitis E Virus Infection in Solid Organ Transplant Patients in the United Kingdom: A Model-Based Economic Evaluation. Value Health 2020; 23:309-318. [PMID: 32197726 DOI: 10.1016/j.jval.2019.09.2751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Despite potentially severe and fatal outcomes, recent studies of solid organ transplant (SOT) recipients in Europe suggest that hepatitis E virus (HEV) infection is underdiagnosed, with a prevalence of active infection of up to 4.4%. OBJECTIVES To determine the cost-effectiveness of introducing routine screening for HEV infection in SOT recipients in the UK. METHODS A Markov cohort model was developed to evaluate the cost-utility of 4 HEV screening options over the lifetime of 1000 SOT recipients. The current baseline of nonsystematic testing was compared with annual screening of all patients by polymerase chain reaction (PCR; strategy A) or HEV-antigen (HEV-Ag) detection (strategy B) and selective screening of patients who have a raised alanine aminotransferase (ALT) value by PCR (strategy C) or HEV-Ag (strategy D). The primary outcome was the incremental cost per quality-adjusted life-year (QALY). We adopted the National Health Service (NHS) perspective and discounted future costs and benefits at 3.5%. RESULTS At a willingness-to-pay of £20 000/QALY gained, systematic screening of SOT patients by any method (strategy A-D) had a high probability (77.9%) of being cost-effective. Among screening strategies, strategy D is optimal and expected to be cost-saving to the NHS; if only PCR testing strategies are considered, then strategy C becomes cost-effective (£660/QALY). These findings were robust against a wide range of sensitivity and scenario analyses. CONCLUSIONS Our model showed that routine screening for HEV in SOT patients is very likely to be cost-effective in the UK, particularly in patients presenting with an abnormal alanine aminotransferase.
Collapse
Affiliation(s)
- Michael J Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, England, UK; Transfusion Microbiology, National Health Service Blood and Transplant, London, England, UK.
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, England, UK; Transfusion Microbiology, National Health Service Blood and Transplant, London, England, UK; Department of Medicine, Imperial College London, London, England, UK
| | - John Cairns
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Frank G Sandmann
- London School of Hygiene and Tropical Medicine, London, England, UK; Statistics, Modelling and Economics Department, National Infection Service, Public Health England, Colindale, London, England, UK
| |
Collapse
|
20
|
May S, Mandal S, Keel P, Haywood B, Ngui SL, Ramsay M, Tedder RS, Ijaz S. Hepatitis B Virus Immunization and Neonatal Acquisition of Persistent Infection in England and Wales. J Infect Dis 2019; 218:726-733. [PMID: 29688415 DOI: 10.1093/infdis/jiy209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/20/2018] [Indexed: 01/27/2023] Open
Abstract
Background It is believed that between 2% and 5% of infants born to hepatitis B virus (HBV)-infected mothers at a high risk of perinatal transmission will become persistently infected despite immunization starting at birth. We investigated factors associated with breakthrough infections. Methods Sixty-nine samples from HBV-infected infants born between 2003 and 2015 were tested for HBV serological and molecular markers. Sequencing and epitope phenotyping were used to investigate alterations in hepatitis B surface antigen (HBsAg) sequence and antigenicity in infants and in mothers known to have transmitted and not to have transmitted virus to their infants. Results Vaccine/hepatitis B immune globulin uptake was complete in the majority of HBV-infected infants. A minority (8 [12%]) had detectable plasma antibody to HBsAg at 12 months. Twenty-five of 68 (37%) infants harbored a virus with amino acid changes in the HBsAg "a" determinant, of which 13 displayed altered HBsAg antigenicity. Viral load was 30-fold higher in maternal samples from those who transmitted. Conclusions Our data provide evidence to suggest that immune selection drives change at mother-infant transmission, resulting in the alteration of HBsAg antigenicity. These changes may play a role in immunization failure, but other factors including viral load may be more important. Continued monitoring of vaccine efficacy is essential.
Collapse
Affiliation(s)
- Shoshanna May
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London
| | - Sema Mandal
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London
| | - Philip Keel
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London
| | - Becky Haywood
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London
| | - Siew Lin Ngui
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London
| | - Mary Ramsay
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London.,University College London, Colindale, United Kingdom.,Microbiology Services, National Health Service Blood and Transplant, Colindale, United Kingdom
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London
| |
Collapse
|
21
|
Tedder RS, Dicks S, Ijaz S, Santiago de Souza NC, Vincente de Paula A, Levy F, Medialdea-Carrera R, Levi JE, Pannuti CS, Carvalho de Sequeira P, Brown DWG, Ushiro Lumb I. Modulated Zika virus NS1 conjugate offers advantages for accurate detection of Zika virus specific antibody in double antigen binding and Ig capture enzyme immunoassays. PLoS One 2019; 14:e0215708. [PMID: 31374094 PMCID: PMC6677316 DOI: 10.1371/journal.pone.0215708] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
The accurate diagnosis and seroprevalence investigations of Zika virus (ZKV) infections remain complex due to cross reactivity with other flaviviruses. Two assay formats, both using labelled Zika virus NS1 antigen as a revealing agent (a double antigen binding assay, DABA, and an immunoglobulin Ig capture assay, G capture) were initially developed and compared with the indirect EuroimmunZ assay for the detection of anti-Zika antibody. Of 147 pre-Zika period serum samples, 39 (27%) were reactive in the EuroimmunZ or the DABA assays, 28 sera concordantly so. Such false reactivity was influenced by the serotype of Dengue virus (DV) to which individuals had been exposed to. Thus, of sera from patients undergoing secondary Dengue virus infection of known serotype, 91%, 45% and 28% of Dengue virus serotype 2, 3 and 4 respectively were reactive in one or more of the three assays. A novel method of quenching false sero-reactivity was therefore developed for the DABA and G capture assays. Initial addition of a single homologous Dengue virus serotype 3 NS1Ag quench significantly ablated false reactivities in the pre-Zika period sera. An equipotent quadrivalent quench comprising homologous Dengue virus serotypes 1 to 4 NS1Ag was shown to be optimum yet retained sensitivity for the detection of specific anti-Zika antibody. Comparing DABA and G capture assays using quenched and unquenched conjugates in comparison with EuroimmunZ early in the course of PCR-confirmed infection indicated that a significant component of the apparent early anti-ZIKA antibody response is likely to be due to a Zika virus-driven anamnestic anti-Dengue virus response. The increased specificity provided by homologous antigen quenching is likely to provide a significant improvement in sero-diagnostics and to be of clinical value.
Collapse
Affiliation(s)
- Richard S. Tedder
- Blood Borne Virus Unit, Virus Reference Department, Public Health England, London, England
- Microbiology Services, NHS Blood and Transplant, London, England
- University College London, London, England
| | - Steve Dicks
- Blood Borne Virus Unit, Virus Reference Department, Public Health England, London, England
- Microbiology Services, NHS Blood and Transplant, London, England
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Public Health England, London, England
- * E-mail:
| | | | - Anderson Vincente de Paula
- Virology Laboratory (LIM-HCFMUSP), Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Flavia Levy
- Flavivirus Reference Laboratory, IOC, Fiocruz, Rio de Janeiro, Brazil
| | - Raquel Medialdea-Carrera
- National Institute for Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, England
| | - José Eduardo Levi
- Virology Laboratory (LIM-HCFMUSP), Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Claudio S. Pannuti
- Virology Laboratory (LIM-HCFMUSP), Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | | | - David W. G. Brown
- Blood Borne Virus Unit, Virus Reference Department, Public Health England, London, England
- Flavivirus Reference Laboratory, IOC, Fiocruz, Rio de Janeiro, Brazil
| | - Ines Ushiro Lumb
- Blood Borne Virus Unit, Virus Reference Department, Public Health England, London, England
- Microbiology Services, NHS Blood and Transplant, London, England
| |
Collapse
|
22
|
Ankcorn M, Gallacher J, Ijaz S, Taha Y, Harvala H, Maclennan S, Thomson EC, Davis C, Singer JB, da Silva Filipe A, Smollett K, Niebel M, Semple MG, Tedder RS, McPherson S. Convalescent plasma therapy for persistent hepatitis E virus infection. J Hepatol 2019; 71:434-438. [PMID: 31075322 PMCID: PMC7126959 DOI: 10.1016/j.jhep.2019.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/17/2019] [Accepted: 04/22/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Michael Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, UK; Transfusion Microbiology, National Health Service Blood and Transplant, London, UK.
| | - Jennifer Gallacher
- Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, UK
| | - Yusri Taha
- Departments of Virology and Infectious Diseases, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Heli Harvala
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Sheila Maclennan
- Transfusion Medicine, National Health Service Blood and Transplant, Leeds, UK
| | - Emma C. Thomson
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Chris Davis
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Joshua B. Singer
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | | | | | - Marc Niebel
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Malcolm G. Semple
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Richard S. Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, UK,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK,Department of Medicine, Imperial College London, London, UK
| | - Stuart McPherson
- Liver Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, UK.
| |
Collapse
|
23
|
Ankcorn MJ, Fox TA, Ijaz S, Nicholas C, Houston E, Longair I, Suri D, Mattes FM, Walker JL, Tedder RS, Sekhar M. Characterising the risk of Hepatitis E virus infection in haematological malignancies: a
UK
prospective prevalence study. Br J Haematol 2019; 186:191-195. [DOI: 10.1111/bjh.15796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Michael J. Ankcorn
- Blood Borne Virus Unit Virus Reference Department National Infection Service Public Health EnglandLondonUK
- Transfusion Microbiology National Health Service Blood and TransplantLondonUK
| | - Thomas A. Fox
- Department of Haematology University College London HospitalsLondonUK
| | - Samreen Ijaz
- Blood Borne Virus Unit Virus Reference Department National Infection Service Public Health EnglandLondonUK
| | - Claire Nicholas
- Department of Haematology University College London HospitalsLondonUK
| | - Eric Houston
- Department of Haematology University College London HospitalsLondonUK
| | - Ian Longair
- Department of Haematology University College London HospitalsLondonUK
| | - Deepak Suri
- Department of Hepatology University College London HospitalsLondonUK
| | - Frank M. Mattes
- Department of Virology University College London HospitalsLondonUK
| | - Jemma L. Walker
- Statistics and Modelling Economics Department Public Health EnglandLondonUK
- Faculty of Epidemiology and Population Health London School of Hygiene and Tropical MedicineLondonUK
| | - Richard S. Tedder
- Blood Borne Virus Unit Virus Reference Department National Infection Service Public Health EnglandLondonUK
- Transfusion Microbiology National Health Service Blood and TransplantLondonUK
- Department of Medicine Imperial College London LondonUK
| | - Mallika Sekhar
- Department of Haematology University College London HospitalsLondonUK
- University College London LondonUK
- Royal Free London Hospital NHS Trust London UK
| |
Collapse
|
24
|
Ankcorn M, Moreira F, Ijaz S, Symes A, Buckland MS, Workman S, Warburton F, Tedder RS, Lowe DM. Absence of Persistent Hepatitis E Virus Infection in Antibody-Deficient Patients Is Associated With Transfer of Antigen-Neutralizing Antibodies From Immunoglobulin Products. J Infect Dis 2018; 219:245-253. [DOI: 10.1093/infdis/jiy504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/16/2018] [Indexed: 02/07/2023] Open
Affiliation(s)
- Mike Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, Public Health England
- Transfusion Microbiology, National Health Service Blood and Transplant
| | - Fernando Moreira
- Department of Clinical Immunology, Royal Free London National Health Service Foundation Trust
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Public Health England
| | - Andrew Symes
- Department of Clinical Immunology, Royal Free London National Health Service Foundation Trust
| | - Matthew S Buckland
- Department of Clinical Immunology, Royal Free London National Health Service Foundation Trust
- Institute of Immunity and Transplantation, University College London, Royal Free Campus
| | - Sarita Workman
- Department of Clinical Immunology, Royal Free London National Health Service Foundation Trust
| | - Fiona Warburton
- Statistics, Modelling, and Economics Department, Public Health England
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, Public Health England
- Transfusion Microbiology, National Health Service Blood and Transplant
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - David M Lowe
- Department of Clinical Immunology, Royal Free London National Health Service Foundation Trust
- Institute of Immunity and Transplantation, University College London, Royal Free Campus
| |
Collapse
|
25
|
Tedder RS, Samuel D, Dicks S, Scott JT, Ijaz S, Smith CC, Adaken C, Cole C, Baker S, Edwards T, Kamara P, Kargbo O, Niazi S, Nwakanma D, d'Alessandro U, Burch G, Doughty H, Brown CS, Andrews N, Glynn JR, van Griensven J, Pollakis G, Paxton WA, Semple MG. Detection, characterization, and enrollment of donors of Ebola convalescent plasma in Sierra Leone. Transfusion 2018; 58:1289-1298. [PMID: 29572862 PMCID: PMC5947131 DOI: 10.1111/trf.14580] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 09/05/2017] [Revised: 01/05/2018] [Accepted: 01/15/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Passive therapy with convalescent plasma provides an early opportunity to intervene in Ebola virus disease (EVD). Methods for field screening and selection of potential donors and quantifying plasma antibody are needed. STUDY DESIGN AND METHODS Recombinant Ebola virus glycoprotein (EBOV GP) was formatted into immunoglobulin G‐capture, competitive, and double‐antigen bridging enzyme immunoassays (EIAs). EVD survivors in Freetown, Sierra Leone, were recruited as potential plasma donors and assessed locally using sera alone and/or paired sera and oral fluids (ORFs). Uninfected controls comprised unexposed Gambians and communities in Western Area, Sierra Leone. Antibody neutralization in selected sera was measured retrospectively in a pseudotype virus assay. RESULTS A total of 115 potential donors were considered for enrollment: 110 plasma samples were concordantly reactive in the three EIAs; three were concordantly unreactive and two were reactive in two of three EIAs (98.2% agreement; 95% confidence interval [CI], 93.9%‐99.8%). In 88 donors with paired ORF and plasma, G‐capture EIA reactivity correlated well in the two analytes (R2 = 0.795). Plasma and ORF from 44 Gambians were unreactive. ORF samples from 338 of 339 unexposed Western Area community controls were unreactive (specificity, 99.7%; 95% CI, 98.4%‐99.7%); ORF samples from 113 of 116 Kerry Town EVD survivors were reactive (sensitivity, 97.4%; 95% CI, 92.5%‐99.5%). Strong reactivity in G‐capture and/or competitive EIAs identified donors with high plasma EBOV GP antibody levels in the double‐antigen bridging assay, correlating with high levels of neutralizing antibody. CONCLUSIONS In‐field testing can qualify convalescent donors for providing high‐titer antibody.
Collapse
Affiliation(s)
- Richard S Tedder
- Blood Borne Virus Unit.,Transfusion Microbiology, National Health Service Blood and Transplant.,Division of Infection and Immunity, University College London, London, UK
| | - Dhan Samuel
- Serology Development Unit, Virus Reference Department, National Infection Service, Public Health England
| | - Steve Dicks
- Blood Borne Virus Unit.,Transfusion Microbiology, National Health Service Blood and Transplant
| | | | | | - Catherine C Smith
- Travel Medicine and International Health Team, Health Protection Scotland, Glasgow, UK
| | - Charlene Adaken
- Institute of Infection and Global Health, National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | | | - Samuel Baker
- National Safe Blood Service, Connaught Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Tansy Edwards
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine
| | - Philip Kamara
- National Safe Blood Service, Connaught Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Osman Kargbo
- National Safe Blood Service, Connaught Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | | | - Umberto d'Alessandro
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.,Medical Research Council, Fajara, Banjul, The Gambia
| | - Graham Burch
- DiaSorin S.p.A, Biotechnology Manufacturing, Dartford, UK
| | - Heidi Doughty
- National Health Service Blood and Transplant.,College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Colin S Brown
- King's Sierra Leone Partnership, King's Centre for Global Health, King's Health Partners and King's College London.,Reference Microbiology, National Infection Service
| | - Nick Andrews
- Statistics, Modelling and Economics Department, Public Health England, London, UK
| | - Judith R Glynn
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine
| | - Johan van Griensven
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Georgios Pollakis
- Institute of Infection and Global Health, National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | - William A Paxton
- Institute of Infection and Global Health, National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK
| | | |
Collapse
|
26
|
Abstract
The hepatitis E virus (HEV) is a major cause of acute hepatitis globally. Genotypes 1 and 2 (G1 and G2) are obligate human pathogens transmitted faeco-orally, leading to epidemics in developing countries. In contrast, genotypes 3 and 4 (G3 and G4) have a wider host range, including humans, but are primarily porcine viruses and are transmitted from animals to humans as a food-borne zoonosis when meat from an infected animal is consumed. HEV is increasingly recognised as a problem in developed countries, including countries in Europe. G3 HEV is now the most common cause of acute viral hepatitis in the UK and cases continue to rise. The majority of these infections are acquired within the UK and thought to be from insufficiently cooked meat, predominantly processed pork meat. Previously thought to only cause self-limiting disease, HEV infection can persist in immunosuppressed patients, which may lead to chronic hepatitis and the rapid development of cirrhosis. Of particular interest to the transfusion community has been the possibility of transfusion-transmitted HEV, which has been reported from countries classically considered HEV-endemic but also non-endemic countries in Europe and Japan. This has prompted some countries to introduce screening for HEV in blood donations.
Collapse
Affiliation(s)
- M J Ankcorn
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - R S Tedder
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, London, UK.,Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| |
Collapse
|
27
|
Brousseau N, Murphy DG, Gilca V, Larouche J, Mandal S, Tedder RS. Acute hepatitis B virus infection with delayed appearance of hepatitis B core antibody in an immunocompromised patient: a case report. J Med Case Rep 2017; 11:111. [PMID: 28412974 PMCID: PMC5393022 DOI: 10.1186/s13256-017-1264-9] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 03/09/2017] [Indexed: 11/29/2022] Open
Abstract
Background Despite the introduction of universal hepatitis B immunization programs worldwide, outbreaks of acute infection still occur in unimmunized individuals. A timely diagnosis of hepatitis B is necessary to ensure adequate clinical care and public health interventions that will reduce transmission. Yet, interpretation of hepatitis B serological markers can be complex. We present a case of hepatitis B with atypical markers, including delayed appearance of hepatitis B core antibody. Case presentation A 62-year-old white woman was identified as a sexual contact of a male individual with acute hepatitis B virus infection. She had a history of recurrent low-grade non-Hodgkin lymphoma and had recently received immunosuppressive therapy. At baseline she had a negative serology and received three double doses (40 μg) of Engerix-B vaccine (hepatitis B vaccine) with a 0-month, 1-month, and 6-month schedule. One month following the last dose, hepatitis B surface antigen was positive in the absence of hepatitis B core antibody. The only sign of infection was a slight elevation of alanine aminotransferase enzymes a few months after first sexual contacts with the male individual. Hepatitis B virus infection was later confirmed despite the absence of hepatitis B core antibody. The development of hepatitis B core antibody was finally noted more than 6 months after the first positive hepatitis B surface antigen and more than 12 months after elevation of alanine aminotransferase enzymes. Immunosuppression including rituximab treatment was the most likely explanation for this serological profile. On her last medical assessment, she had not developed HBeAg seroconversion despite lower hepatitis B virus deoxyribonucleic acid levels with tenofovir treatment. Conclusions When confronted with positive hepatitis B surface antigen in the absence of hepatitis B core antibody, consideration should be given to the possibility of both acute and persistent infection particularly in the setting of immunosuppression so that appropriate clinical management and public health interventions can take place. Given the increasing use of biologicals such as anti-tumor necrosis factor therapies either alone or with other immunosuppressive agents, this phenomenon may be encountered more frequently.
Collapse
Affiliation(s)
- Nicholas Brousseau
- CIUSSS de la Mauricie-et-Centre-du-Québec, 858 terrasse Turcotte, Trois-Rivières, Québec, G9A 5C5, Canada. .,Institut national de santé publique du Québec, 945 av Wolfe, Québec, G1V 5B3, Canada.
| | - Donald G Murphy
- Institut national de santé publique du Québec, 945 av Wolfe, Québec, G1V 5B3, Canada
| | - Vladimir Gilca
- Institut national de santé publique du Québec, 945 av Wolfe, Québec, G1V 5B3, Canada
| | - Jacynthe Larouche
- CIUSSS de la Mauricie-et-Centre-du-Québec, 858 terrasse Turcotte, Trois-Rivières, Québec, G9A 5C5, Canada
| | - Sema Mandal
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | | |
Collapse
|
28
|
Tedder RS, Ijaz S, Kitchen A, Ushiro-Lumb I, Tettmar KI, Hewitt P, Andrews N. Hepatitis E risks: pigs or blood-that is the question. Transfusion 2017; 57:267-272. [DOI: 10.1111/trf.13976] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/10/2016] [Accepted: 11/22/2016] [Indexed: 01/01/2023]
Affiliation(s)
- Richard S. Tedder
- Virus Reference Department; National Infection Service, Public Health England; London UK
- NHS Blood and Transplant; London UK
- University College London; London UK
| | - Samreen Ijaz
- Virus Reference Department; National Infection Service, Public Health England; London UK
| | | | | | | | | | - Nick Andrews
- Statistics Modelling and Economics Department; National Infection Service, Public Health England; London UK
| |
Collapse
|
29
|
Abstract
Acute hepatitis E is becoming increasingly recognised in Europe with up to 40% of the population in Southern France being exposed to the virus, which is harboured in pigs. Patients with known liver disease may present with acute hepatitis E and present a diagnostic challenge. For example patients with autoimmune hepatitis (AIH) who are immunosuppressed and contract hepatitis E may be at increased risk of developing chronicity due to concurrent immunosuppression. Importantly, the diagnosis may be missed with the infection misdiagnosed as an autoimmune flare, and immunosuppression increased by the attending physician, thus enhancing the risk of chronicity of infection leading to progressive liver injury in immunocompromised patients. We report a case of acute hepatitis E in a patient with AIH and discuss the features that helped us differentiating it from an autoimmune flare.
Collapse
Affiliation(s)
- Giorgio Calisti
- Department of Virology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dianne N Irish
- Department of Virology, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Samreen Ijaz
- Blood Borne Virus Unit, MS-Colindale, Public Health England, London, United Kingdom
| | - Richard S Tedder
- Blood Borne Virus Unit, MS-Colindale, Public Health England, London, United Kingdom
| | - Kevin Moore
- Centre for Hepatology, Royal Free and University College Medical School, University College London, United Kingdom
| |
Collapse
|
30
|
Edwards SG, Grover D, Scott C, Tedder RS, Pillay D, Copas A, Miller RF. Cytomegalovirus viral load testing of blood using quantitative polymerase chain reaction in acutely unwell HIV-1-positive patients lacks diagnostic utility. Int J STD AIDS 2016; 18:321-3. [PMID: 17524192 DOI: 10.1258/095646207780749600] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We examined the usefulness of measuring cytomegalovirus (CMV) viral load (VL) in blood using quantitative polymerase chain reaction (qPCR) in establishing a diagnosis of CMV end-organ disease in consecutive unwell HIV-infected patients. The indication for testing for CMV, CD4 count, CMV VL and presence of CMV end-organ disease were abstracted from case-notes. During a 42-month period, 216 tests were performed in 181 patients; the majority (61%) had CD4 counts <100 cells/ μL. The prevalence of detectable CMV by qPCR was 43.5% (94/216) with a prevalence of CMV end-organ disease of 7.4% (16/216). Of patients with CMV detectable by qPCR, 72 % (50/69) had CD4 counts <100 cells/ μL. For patients with definite CMV end-organ disease, the positive predictive value of detectable CMV by qPCR was 10% (9/94), and the negative predictive value was 98% (119/122). In acutely unwell HIV-infected patients, detection of CMV by qPCR is a poor predictor of CMV end-organ disease.
Collapse
Affiliation(s)
- S G Edwards
- Department of Genitourinary Medicine, Mortimer Market Centre, Camden Primary Care Trust, London WC1E 6JB, UK
| | | | | | | | | | | | | |
Collapse
|
31
|
Grierson S, Heaney J, Cheney T, Morgan D, Wyllie S, Powell L, Smith D, Ijaz S, Steinbach F, Choudhury B, Tedder RS. Prevalence of Hepatitis E Virus Infection in Pigs at the Time of Slaughter, United Kingdom, 2013. Emerg Infect Dis 2016. [PMID: 26196216 PMCID: PMC4517718 DOI: 10.3201/eid2108.141995] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Pigs raised in the United Kingdom are unlikely to be the source of UK human infections. Since 2010, reports of infection with hepatitis E virus (HEV) have increased in England and Wales. Despite mounting evidence regarding the zoonotic potential of porcine HEV, there are limited data on its prevalence in pigs in the United Kingdom. We investigated antibody prevalence, active infection, and virus variation in serum and cecal content samples from 629 pigs at slaughter. Prevalence of antibodies to HEV was 92.8% (584/629), and HEV RNA was detected in 15% of cecal contents (93/629), 3% of plasma samples (22/629), and 2% of both (14/629). However, although HEV is prevalent in pigs in the United Kingdom and viremic pigs are entering the food chain, most (22/23) viral sequences clustered separately from the dominant type seen in humans. Thus, pigs raised in the United Kingdom are unlikely to be the main source of human HEV infections in the United Kingdom. Further research is needed to identify the source of these infections.
Collapse
|
32
|
Tedder RS, Tettmar KI, Brailsford SR, Said B, Ushiro-Lumb I, Kitchen A, Morgan D, Lattimore S, Tossell J, Ijaz S, Hewitt PE. Virology, serology, and demography of hepatitis E viremic blood donors in South East England. Transfusion 2016; 56:1529-36. [PMID: 26841005 DOI: 10.1111/trf.13498] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 12/06/2015] [Accepted: 12/06/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) Genotype 3 (G3) in England comprises two principal phylogenetic groups (Group 1 and Group 2) and can be transmitted by transfusion. Unselected screening identified 79 viremic donors; 76 participated in a follow-up study. STUDY DESIGN AND METHODS Viral RNA dynamics, phylogenetics, and seroconversion were characterized in the donors. Detailed demographic, travel, clinical, and lifestyle questionnaires were undertaken. RESULTS The majority of viremic individuals (57/79) were seronegative at time of donation but all seroconverted. Viremia was short-lived, with a median of 6.5 weeks to confirmed viral clearance. All infections were acquired in the United Kingdom and were G3, with Group 2 viruses predominating (43/54; 80%). Infection was associated with some clinical symptoms both at and after donation (8/77; 10%). Viral loads and symptoms were more pronounced in Group 1 infections. There was no serologic evidence of reinfection. Donors were more commonly male (p = 0.002); both male and female donors were older than comparator donors. Animal contact was unlikely to be the source of infection. Consumption of chicken and pig meat was common to all infected donors; processed pig meat was most commonly purchased from one particular retail chain. CONCLUSION Viremic donors represent primary infection in older members of the community and reflect a widespread zoonotic in the United Kingdom. The two phylogenetic groups of HEV G3 display different pathogenicity and the more common Group 2 appears less adapted to humans. There are no objective demographic criteria that can identify donors at enhanced HEV risk.
Collapse
Affiliation(s)
- Richard S Tedder
- Microbiology Services, National Health Service Blood and Transplant, London.,Blood Borne Virus Unit, Virus Reference Department, National Infection Service.,University College London, London, UK
| | - Kate I Tettmar
- Microbiology Services, National Health Service Blood and Transplant, London.,Blood Borne Virus Unit, Virus Reference Department, National Infection Service
| | - Su R Brailsford
- Microbiology Services, National Health Service Blood and Transplant, London.,NHSBT/PHE Epidemiology Unit, Department of Immunisation, Hepatitis and Blood Safety
| | - Bengu Said
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London
| | - Ines Ushiro-Lumb
- Microbiology Services, National Health Service Blood and Transplant, London.,Blood Borne Virus Unit, Virus Reference Department, National Infection Service
| | - Alan Kitchen
- Microbiology Services, National Health Service Blood and Transplant, London
| | - Dilys Morgan
- Emerging Infections and Zoonoses, National Infection Service, Public Health England, London
| | - Sam Lattimore
- NHSBT/PHE Epidemiology Unit, Department of Immunisation, Hepatitis and Blood Safety
| | - Joanne Tossell
- Microbiology Services, National Health Service Blood and Transplant, London
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, National Infection Service
| | - Patricia E Hewitt
- Microbiology Services, National Health Service Blood and Transplant, London
| |
Collapse
|
33
|
Lambe T, Rampling T, Samuel D, Bowyer G, Ewer KJ, Venkatraman N, Edmans M, Dicks S, Hill AVS, Tedder RS, Gilbert SC. Detection of Vaccine-Induced Antibodies to Ebola Virus in Oral Fluid. Open Forum Infect Dis 2016; 3:ofw031. [PMID: 27004234 PMCID: PMC4796941 DOI: 10.1093/ofid/ofw031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/05/2016] [Indexed: 11/13/2022] Open
Abstract
Blood sampling to assess production of antigen-specific antibodies after immunization is commonly performed, but it presents logistical difficulties for trials carried out during an infectious disease outbreak. In this study, we show that antibodies may be reliably detected in oral fluid collected in a minimally invasive manner without use of sharps. Clinical Trials Registration. NCT02240875.
Collapse
Affiliation(s)
| | | | - Dhan Samuel
- Virus Reference Department , National Infection Service, Public Health England
| | | | | | | | | | - Steve Dicks
- Transfusion Microbiology , National Health Service Blood and Transport , Colindale, London , United Kingdom
| | | | - Richard S Tedder
- Virus Reference Department , National Infection Service, Public Health England
| | | |
Collapse
|
34
|
Smith DB, Ijaz S, Tedder RS, Hogema B, Zaaijer HL, Izopet J, Bradley-Stewart A, Gunson R, Harvala H, Kokki I, Simmonds P. Variability and pathogenicity of hepatitis E virus genotype 3 variants. J Gen Virol 2015; 96:3255-3264. [PMID: 26282123 PMCID: PMC4806580 DOI: 10.1099/jgv.0.000264] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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] [Indexed: 12/25/2022] Open
Abstract
Infection with hepatitis E virus (HEV) can be clinically inapparent or produce symptoms and signs of hepatitis of varying severity and occasional fatality. This variability in clinical outcomes may reflect differences in host susceptibility or the presence of virally encoded determinants of pathogenicity. Analysis of complete genome sequences supports the division of HEV genotype 3 (HEV-3) variants into three major clades: 3ra comprising HEV isolates from rabbits, and 3efg and 3abchij comprising the corresponding named subtypes derived from humans and pigs. Using this framework, we investigated associations between viral genetic variability of HEV-3 in symptomatic and asymptomatic infections by comparing HEV-3 subgenomic sequences previously obtained from blood donors with those from patients presenting with hepatitis in the UK (54 blood donors, 148 hepatitis patients), the Netherlands (38 blood donors, 119 hepatitis patients), France (24 blood donors, 55 hepatitis patients) and Germany (14 blood donors, 36 hepatitis patients). In none of these countries was evidence found for a significant association between virus variants and patient group (P>0.05 Fisher's exact test). Furthermore, within a group of 123 patients in Scotland with clinically apparent HEV infections, we found no evidence for an association between variants of HEV-3 and disease severity or alanine aminotransferase level. The lack of detectable virally encoded determinants of disease outcomes in HEV-3 infection implies a more important role for host factors in its clinical phenotype.
Collapse
Affiliation(s)
- Donald B Smith
- University of Edinburgh, CIIE, Ashworth Laboratories, King's Buildings, Edinburgh EH9 3FL, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, MS-Colindale, Public Health England, London NW9 5EQ, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Virus Reference Department, MS-Colindale, Public Health England, London NW9 5EQ, UK.,University College London, Gower Street, London WC1E 6BT, UK
| | - Boris Hogema
- Department of Blood-borne Infections, Sanquin Research, PO Box 9190, 1006 AD Amsterdam, The Netherlands
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Sanquin Research, PO Box 9190, 1006 AD Amsterdam, The Netherlands
| | - Jacques Izopet
- Institut National de la Sante et de la Recherche Medicale Unite 1043, Toulouse, France
| | | | - Rory Gunson
- West of Scotland Specialist Virology Centre, New Lister Building, Glasgow, UK
| | - Heli Harvala
- Specialist Virology Centre, Royal Infirmary of Edinburgh, UK.,Public Health Agency of Sweden (previously Swedish Institute for Communicable Disease Control), Solna, Sweden.,European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Inka Kokki
- Specialist Virology Centre, Royal Infirmary of Edinburgh, UK
| | - Peter Simmonds
- University of Edinburgh, Roslin Institute, Easter Bush, Edinburgh EH25 9RG, UK
| |
Collapse
|
35
|
Patel P, Tuke P, Tettmar K, Cloutman-Green E, Hartley J, Klein N, Veys P, Tedder RS. No evidence of transfusion transmission of Adenovirus and Epstein-Barr virus infections in paediatric recipients post-bone marrow transplant. Vox Sang 2015; 109:95-7. [PMID: 25827634 DOI: 10.1111/vox.12256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/14/2014] [Revised: 12/16/2014] [Accepted: 01/12/2015] [Indexed: 11/30/2022]
Abstract
Adenovirus and Epstein-Barr virus can cause significant morbidity and mortality in paediatric patients post-bone marrow transplant. The source of infection is thought to be either reactivation of latent viruses or primary infection. We have investigated whether transfusion of blood components from viraemic donors could provide a route of primary infection in these patients and sought the prevalence of viraemia in the blood donor population from England. In 32 linked donor/recipient samples and 300 unselected blood donors, we found no evidence to suggest that these infections in paediatric bone marrow transplant recipients had been acquired from transfused blood components.
Collapse
Affiliation(s)
- P Patel
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - P Tuke
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - K Tettmar
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - E Cloutman-Green
- Camelia Botnar Laboratory, Great Ormond Street Hospital, London, UK
| | - J Hartley
- Camelia Botnar Laboratory, Great Ormond Street Hospital, London, UK
| | - N Klein
- Infectious Diseases and Microbiology, Institute of Child Health, London, UK
| | - P Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, UK
| | - R S Tedder
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| |
Collapse
|
36
|
May S, Ngui SL, Collins S, Lattimore S, Ramsay M, Tedder RS, Ijaz S. Molecular epidemiology of newly acquired hepatitis C infections in England 2008-2011: genotype, phylogeny and mutation analysis. J Clin Virol 2014. [PMID: 25728071 DOI: 10.1016/j.jcv.2014.12.01410.1016/j.jcv.2014.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Analysis of laboratory testing data collected through the Sentinel Surveillance programme has provided a method for identifying individuals who have recently acquired their hepatitis C virus (HCV) infection. Access to samples from these individuals provided a rare opportunity to undertake molecular characterization studies. OBJECTIVES To describe the epidemiology and genetic diversity of hepatitis C in recent seroconverter infections and to predict how this will impact on HCV treatment and control. STUDY DESIGN One hundred and forty seven samples were available from individuals, identified to have recently acquired their HCV infection. Genotype determination with additional phylogenetic analysis was carried out on NS5B sequences. Analysis across the NS3 region investigated the presence of antiviral resistance mutations. Where possible, molecular data was linked to demographic and risk/behavioural factor information. RESULTS The majority of new infections occurred in males with a mean age of 37 years. The most commonly observed genotypes were 1a (49%) and 3a (42%) and injecting drug use (58%) was the most common risk factor. Genotype distribution differed between persons who inject drugs and those with other risk factors suggesting two possible epidemics. Phylogenetic analysis indicated possible transmission networks within specific risk groups. Amino acid changes associated with antiviral resistance were noted in the NS3 region in some samples. CONCLUSIONS Continued surveillance of linked molecular, virological, demographic and epidemiological information on recently acquired infections will contribute to understanding the on-going HCV epidemic in England.
Collapse
Affiliation(s)
- Shoshanna May
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Siew Lin Ngui
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Sarah Collins
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Sam Lattimore
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mary Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; Division of Infection and Immunity, University College London, Gower Street, London WC1E 6BT, UK; Transfusion Microbiology, NHS Blood and Transplant, Colindale Avenue, London, NW9 5BG, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
| |
Collapse
|
37
|
May S, Ngui SL, Collins S, Lattimore S, Ramsay M, Tedder RS, Ijaz S. Molecular epidemiology of newly acquired hepatitis C infections in England 2008-2011: genotype, phylogeny and mutation analysis. J Clin Virol 2014; 64:6-11. [PMID: 25728071 DOI: 10.1016/j.jcv.2014.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/19/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Analysis of laboratory testing data collected through the Sentinel Surveillance programme has provided a method for identifying individuals who have recently acquired their hepatitis C virus (HCV) infection. Access to samples from these individuals provided a rare opportunity to undertake molecular characterization studies. OBJECTIVES To describe the epidemiology and genetic diversity of hepatitis C in recent seroconverter infections and to predict how this will impact on HCV treatment and control. STUDY DESIGN One hundred and forty seven samples were available from individuals, identified to have recently acquired their HCV infection. Genotype determination with additional phylogenetic analysis was carried out on NS5B sequences. Analysis across the NS3 region investigated the presence of antiviral resistance mutations. Where possible, molecular data was linked to demographic and risk/behavioural factor information. RESULTS The majority of new infections occurred in males with a mean age of 37 years. The most commonly observed genotypes were 1a (49%) and 3a (42%) and injecting drug use (58%) was the most common risk factor. Genotype distribution differed between persons who inject drugs and those with other risk factors suggesting two possible epidemics. Phylogenetic analysis indicated possible transmission networks within specific risk groups. Amino acid changes associated with antiviral resistance were noted in the NS3 region in some samples. CONCLUSIONS Continued surveillance of linked molecular, virological, demographic and epidemiological information on recently acquired infections will contribute to understanding the on-going HCV epidemic in England.
Collapse
Affiliation(s)
- Shoshanna May
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Siew Lin Ngui
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Sarah Collins
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Sam Lattimore
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mary Ramsay
- Immunisation, Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Richard S Tedder
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; Division of Infection and Immunity, University College London, Gower Street, London WC1E 6BT, UK; Transfusion Microbiology, NHS Blood and Transplant, Colindale Avenue, London, NW9 5BG, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Microbiology Service - Colindale, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
| |
Collapse
|
38
|
Garson JA, Ferns RB, Grant PR, Ijaz S, Nastouli E, Szypulska R, Tedder RS. Corrigendum to “Garson et al., Minor groove binder modification of widely used TaqMan probe for hepatitis E virus reduces risk of false negative real-time PCR results” [J. Virol. Methods 186 (2012) 157–160]. J Virol Methods 2014. [DOI: 10.1016/j.jviromet.2014.09.002] [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: 11/17/2022]
|
39
|
Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, Kennedy ITR, Kitchen A, Patel P, Poh J, Russell K, Tettmar KI, Tossell J, Ushiro-Lumb I, Tedder RS. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet 2014; 384:1766-73. [PMID: 25078306 DOI: 10.1016/s0140-6736(14)61034-5] [Citation(s) in RCA: 379] [Impact Index Per Article: 37.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The prevalence of hepatitis E virus (HEV) genotype 3 infections in the English population (including blood donors) is unknown, but is probably widespread, and the virus has been detected in pooled plasma products. HEV-infected donors have been retrospectively identified through investigation of reported cases of possible transfusion-transmitted hepatitis E. The frequency of HEV transmission by transfusion and its outcome remains unknown. We report the prevalence of HEV RNA in blood donations, the transmission of the virus through a range of blood components, and describe the resulting morbidity in the recipients. METHODS From Oct 8, 2012, to Sept 30, 2013, 225,000 blood donations that were collected in southeast England were screened retrospectively for HEV RNA. Donations containing HEV were characterised by use of serology and genomic phylogeny. Recipients, who received any blood components from these donations, were identified and the outcome of exposure was ascertained. FINDINGS 79 donors were viraemic with genotype 3 HEV, giving an RNA prevalence of one in 2848. Most viraemic donors were seronegative at the time of donation. The 79 donations had been used to prepare 129 blood components, 62 of which had been transfused before identification of the infected donation. Follow-up of 43 recipients showed 18 (42%) had evidence of infection. Absence of detectable antibody and high viral load in the donation rendered infection more likely. Recipient immunosuppression delayed or prevented seroconversion and extended the duration of viraemia. Three recipients cleared longstanding infection after intervention with ribavirin or alteration in immunosuppressive therapy. Ten recipients developed prolonged or persistent infection. Transaminitis was common, but short-term morbidity was rare; only one recipient developed apparent but clinically mild post-transfusion hepatitis. INTERPRETATION Our findings suggest that HEV genotype 3 infections are widespread in the English population and in blood donors. Transfusion-transmitted infections rarely caused acute morbidity, but in some immunosuppressed patients became persistent. Although at present blood donations are not screened, an agreed policy is needed for the identification of patients with persistent HEV infection, irrespective of origin, so that they can be offered antiviral therapy. FUNDING Public Health England and National Health Service Blood and Transplant.
Collapse
Affiliation(s)
- Patricia E Hewitt
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Su R Brailsford
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Rachel Brett
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Steven Dicks
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Becky Haywood
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Iain T R Kennedy
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Alan Kitchen
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Poorvi Patel
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - John Poh
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Katherine Russell
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Kate I Tettmar
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Joanne Tossell
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - Ines Ushiro-Lumb
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK
| | - Richard S Tedder
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK; Blood Borne Virus Unit, Virus Reference Department, Microbiology Services, Public Health England, London, UK; University College London, Gower Street, London, UK.
| |
Collapse
|
40
|
Rosenberg GK, Lattimore S, Brailsford SR, Hewitt PE, Tettmar KI, Kitchen AD, Ijaz S, Tedder RS. Acute hepatitis B in blood donors over a 5-year period in England and North Wales: who is getting infected? Transfusion 2013; 54:1660-5. [DOI: 10.1111/trf.12497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/02/2013] [Accepted: 10/08/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Gillian K. Rosenberg
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Sam Lattimore
- NHS Blood and Transplant/Public Health England Epidemiology Unit; NHS Blood and Transplant; London UK
| | - Susan R. Brailsford
- NHS Blood and Transplant/Public Health England Epidemiology Unit; NHS Blood and Transplant; London UK
- Clinical Transfusion Microbiology; NHS Blood and Transplant; London UK
| | | | - Kate I. Tettmar
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Alan D. Kitchen
- National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant; London UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
| | - Richard S. Tedder
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant; London UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services; Public Health England; London UK
- Division of Infection and Immunity; University College London; London UK
| |
Collapse
|
41
|
Ijaz S, Said B, Boxall E, Smit E, Morgan D, Tedder RS. Indigenous hepatitis E in England and wales from 2003 to 2012: evidence of an emerging novel phylotype of viruses. J Infect Dis 2013; 209:1212-8. [PMID: 24273173 DOI: 10.1093/infdis/jit652] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Enhanced surveillance and molecular characterisation studies of hepatitis E virus (HEV) in England and Wales have been undertaken since 2003. The dynamics of hepatitis E have changed recently with an increase in the number of indigenous cases and an observed viral shift. METHODS HEV antibody and RNA data were analysed to ascertain the annual number of acute infections, the HEV genotype disposition and viral phylogeny. These data were investigated in the context of collected travel history and demographic data. RESULTS In total, 2713 acute hepatitis E cases were diagnosed, of which 1376 were indigenous infections. Travel associated cases remained steady and mainly associated with Genotype 1 infections. In contrast, major fluctuations were noted in indigenously-acquired cases with a dramatic year on year increase during 2010-2012. Molecular characterisation demonstrated indigenous infections to cluster into two distinct phylogenetic groups with the emergence of a novel group of Genotype 3 viruses coinciding with the recent increase in cases. CONCLUSIONS HEV infection rates are dynamic in England and Wales, influenced by changing trends in indigenously-acquired cases. The recent increase in indigenous cases and the emergence of indigenous viruses not commonly circulating prior to 2010 suggest that the risk of acquiring HEV has changed.
Collapse
Affiliation(s)
- Samreen Ijaz
- Blood Borne Virus Unit, MS-Colindale, Public Health England, London NW9 5EQ, United Kingdom
| | | | | | | | | | | |
Collapse
|
42
|
Andersson MI, Maponga TG, Ijaz S, Barnes J, Theron GB, Meredith SA, Preiser W, Tedder RS. The epidemiology of hepatitis B virus infection in HIV-infected and HIV-uninfected pregnant women in the Western Cape, South Africa. Vaccine 2013; 31:5579-84. [PMID: 23973500 PMCID: PMC3898695 DOI: 10.1016/j.vaccine.2013.08.028] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 07/31/2013] [Accepted: 08/09/2013] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Persistent hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in sub-Saharan Africa. The HIV epidemic has the potential to affect its biology. Immunisation protocols established in the pre-HIV era are based upon data showing predominantly horizontal infant transmission. This study aimed to determine whether HIV co-infection will change the epidemiology of HBV both by increasing infectivity and by favouring the escape of viruses bearing phenotypically altered HBsAg. METHODS This retrospective cross-sectional study used antenatal samples from the 2008 Antenatal Sentinel HIV and Syphilis Prevalence Survey in the Western Cape, South Africa. All HIV-infected women were age and race-matched to HIV-uninfected women. Samples were tested for serological markers of HBV and HDV infection. HBV viral load, consensus sequencing and genotyping were performed. Luminex technology was used to determine HBsAg phenotype. All samples from HIV-infected women were tested for traces of antiretroviral drugs by mass spectrometry. RESULTS This study showed a trend toward loss of immune control of HBV in HIV-infected women with 3.4% of samples containing HBsAg, 18.9% contained HBeAg. In contrast, 2.9% of samples from HIV-uninfected women contained HBsAg and 17.1% of these HBeAg. The median HBV load in the HIV-infected group was 9.72×10(7)IU/ml and in the HIV-uninfected group 1.19×10(6)IU/ml. Genotyping showed 63/68 samples belonged to genotype A and the remainder genotype D. Mutations in the precore region were found in 35% and 33% of samples from HIV-infected and HIV-uninfected respectively. Although no major epitope ablation was found, marked variation in HBsAg profiles in HIV-infected group was demonstrated. No HDV infection was detected. CONCLUSION HIV-HBV co-infected women exhibit a degree of immune escape. One in six HBV-infected pregnant women, irrespective of HIV status is HBeAg seropositive. HBV immunization of newborns in sub-Saharan Africa should be implemented.
Collapse
Affiliation(s)
- M I Andersson
- Division of Medical Virology, University of Stellenbosch/National Health Laboratory Service, Tygerberg, South Africa.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Rosenberg GK, Lattimore S, Brailsford SR, Hewitt PE, Tettmar KI, Kitchen AD, Ijaz S, Tedder RS. The diversity of chronic hepatitis B virus infections within blood donors in England and North Wales 2005 through 2010. Transfusion 2013; 53:2467-76. [DOI: 10.1111/trf.12003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/08/2012] [Accepted: 10/11/2012] [Indexed: 12/14/2022]
Affiliation(s)
- Gillian K. Rosenberg
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Sam Lattimore
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Susan R. Brailsford
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Patricia E. Hewitt
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Kate I. Tettmar
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Alan D. Kitchen
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Samreen Ijaz
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| | - Richard S. Tedder
- National Transfusion Microbiology Laboratories; NHS Blood and Transplant/Health Protection Agency Epidemiology Unit; Clinical Transfusion Microbiology; National Transfusion Microbiology Reference Laboratory; NHS Blood and Transplant
- Blood Borne Virus Unit; Viral Reference Department; Microbiology Services; Health Protection Agency; Colindale London UK
| |
Collapse
|
44
|
Tedder RS, Bissett SL, Myers R, Ijaz S. The 'Red Queen' dilemma--running to stay in the same place: reflections on the evolutionary vector of HBV in humans. Antivir Ther 2013; 18:489-96. [PMID: 23792884 DOI: 10.3851/imp2655] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2012] [Indexed: 01/28/2023]
Abstract
BACKGROUND Estimates for the evolutionary rate of HBV until now have been interpreted as showing that HBV is a relatively recent acquisition for mankind. The existence of defined HBV genotypes is thought to represent past founder effects. We have explored virus mutation in a group of 48 persistently infected blood donors sampled at two points in time and suggest otherwise. METHODS HBV-infected donors were detected by hepatitis B surface antigen (HBsAg) screening and staged by hepatitis B e markers. Serum DNA from those persistently infected with HBV was characterized by consensus sequencing and the amino acid sequences inferred. These were compared against consensus genotype sequences and divergence measured at two points in time. RESULTS Rates of viral mutation were higher across both HBsAg and hepatitis B core antigen in the group of donors seropositive for hepatitis B e antibody (1.36×10⁻³ and 1.54×10⁻³ changes per residue per year, respectively) than in those seropositive for hepatitis B e antigen (4.59×10⁻⁴ and 6.62×10⁻⁴ changes per residue per year, respectively). Codon mutations reverting to the genotype consensus were commonly seen. Codon changes were clustered close to the C-terminal region of HBsAg and were accommodated in overlapping polymerase by synonymous substitutions. CONCLUSIONS It is suggested that in vivo HBV behaves as a self-normalizing meme and mutational rates, although high, do not lead to significant change over time in a persistent infection. This would be compatible with co-evolution within its human host and introduction within humans being an ancient occurrence.
Collapse
|
45
|
Garson JA, Patel P, McDonald C, Ball J, Rosenberg G, Tettmar KI, Brailsford SR, Pitt T, Tedder RS. Evaluation of an ethidium monoazide-enhanced 16S rDNA real-time polymerase chain reaction assay for bacterial screening of platelet concentrates and comparison with automated culture. Transfusion 2013; 54:870-8. [PMID: 23701338 PMCID: PMC4282358 DOI: 10.1111/trf.12256] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 02/11/2013] [Revised: 04/11/2013] [Accepted: 04/15/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Culture-based systems are currently the preferred means for bacterial screening of platelet (PLT) concentrates. Alternative bacterial detection techniques based on nucleic acid amplification have also been developed but these have yet to be fully evaluated. In this study we evaluate a novel 16S rDNA polymerase chain reaction (PCR) assay and compare its performance with automated culture. STUDY DESIGN AND METHODS A total of 2050 time-expired, 176 fresh, and 400 initial-reactive PLT packs were tested by real-time PCR using broadly reactive 16S primers and a "universal" probe (TaqMan, Invitrogen). PLTs were also tested using a microbial detection system (BacT/ALERT, bioMérieux) under aerobic and anaerobic conditions. RESULTS Seven of 2050 (0.34%) time-expired PLTs were found repeat reactive by PCR on the initial nucleic acid extract but none of these was confirmed positive on testing frozen second aliquots. BacT/ALERT testing also failed to confirm any time-expired PLTs positive on repeat testing, although 0.24% were reactive on the first test. Three of the 400 "initial-reactive" PLT packs were found by both PCR and BacT/ALERT to be contaminated (Escherichia coli, Listeria monocytogenes, and Streptococcus vestibularis identified) and 14 additional packs were confirmed positive by BacT/ALERT only. In 13 of these cases the contaminating organisms were identified as anaerobic skin or oral commensals and the remaining pack was contaminated with Streptococcus pneumoniae. CONCLUSION These results demonstrate that the 16S PCR assay is less sensitive than BacT/ALERT and inappropriate for early testing of concentrates. However, rapid PCR assays such as this may be suitable for a strategy of late or prerelease testing.
Collapse
Affiliation(s)
- Jeremy A Garson
- National Transfusion Microbiology Laboratories, NHSBT/HPA Epidemiology Unit, NHS Blood and Transplant, Colindale, London; Research Department of Infection, Division of Infection and Immunity, University College London, London; Blood Borne Virus Unit, Viral Reference Department, Centre for Infections, Health Protection Agency, Colindale, London, UK
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kakisi OK, Robinson MJ, Tettmar KI, Tedder RS. The rise and fall of XMRV. Transfus Med 2013; 23:142-51. [PMID: 23692013 DOI: 10.1111/tme.12049] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 04/23/2013] [Accepted: 05/01/2013] [Indexed: 12/25/2022]
Abstract
Due to the relatively recent emergence of the human T-lymphotropic and the human immunodeficiency viruses, enthusiasm for the identification of novel viruses, especially retroviruses, with pathogenic potential in humans, remains high. Novel technologies are now available with the ability to search for unknown viruses, such as gene arrays and new generation sequencing of tissue and other samples. In 2006, chip technology identified a novel retrovirus in human prostate cancer (PCa) tissue samples. Due to close homology to a mouse retrovirus, the virus was named xenotropic murine leukaemia virus-related virus (XMRV). Ever since the initial disease association with PCa, XMRV has stirred a lot of attention and concern worldwide for the medical community, public health officials and in particular global transfusion services. Public response, in this new era of electronic communication and advocacy was rapid, wide and unprecedented. In this review, we outline the course of biomedical research efforts that were put forward internationally in the process of determining the risk to the human population, the response of the blood banking community and review the current state of knowledge of xenotropic murine retroviruses. Although XMRV is no longer regarded as an infection of humans, a lesson was learnt in modern virology that holds deeper implications for biomedical research, particularly stem cell generation and transplantation practices.
Collapse
Affiliation(s)
- O K Kakisi
- Transfusion Microbiology Research and Development, National Transfusion Microbiology Laboratories, NHS Blood and Transplant, Colindale, London, UK.
| | | | | | | |
Collapse
|
47
|
Tedder RS, Tuke P, Wallis N, Wright M, Nicholson L, Grant PR. Therapy-induced clearance of HCV core antigen from plasma predicts an end of treatment viral response. J Viral Hepat 2013; 20:65-71. [PMID: 23231086 DOI: 10.1111/j.1365-2893.2012.01630.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
During viral assembly, viral proteins are released into plasma and can be used to infer viral load. The Architect hepatitis C virus (HCV) core antigen (Ag) assay is a potential alternative to HCV RNA quantification for measuring response to therapy and predicting an end of treatment viral response (EOTR). The HCVp22Ag assay was used to infer viral load in 68 window RNA-containing samples and in 284 samples from baseline to week 14 of ribavirin/interferon treatment in 23 patients with EOTR including three who relapsed, 20 not achieving EOTR and 11 controls. HCV Ag and RNA correlated well (r = 0.86) with linear dose responses on dilution. In patients on therapy and control patients, plasma HCV antigen was detected in 51 of 54 with an interpolated LOD cut off between 10(3) and 10(4) RNA IU/mL. Plasma HCV antigenaemia and plasma RNA levels were significantly different in EOTR from non-EOTR patients at 3 days after treatment start and all times thereafter. Positive and negative EOTR predictive values for HCV RNA >2 log drop and HCV Ag loss at 12 weeks were 70% and 74%, 85% and 93% respectively. HCV Ag reactivity has a linear dose response independent of genotype and correlates well with HCV RNA. The failure to clear HCV Ag is as accurate as the failure to clear HCV RNA at twelve weeks into therapy in predicting the likelihood of failure to achieve EOTR. HCV Ag potentially offers a convenient alternative to RNA measurement for defining a futility flag in HCV therapy.
Collapse
Affiliation(s)
- R S Tedder
- Virus Reference Department, Health Protection Agency, London, UK.
| | | | | | | | | | | |
Collapse
|
48
|
Tedder RS, Rodger AJ, Fries L, Ijaz S, Thursz M, Rosenberg W, Naoumov N, Banatvala J, Williams R, Dusheiko G, Chokshi S, Wong T, Rosenberg G, Moreea S, Bassendine M, Jacobs M, Mills PR, Mutimer D, Ryder SD, Bathgate A, Hussaini H, Dillon JF, Wright M, Bird G, Collier J, Anderson M, Johnson AM. The diversity and management of chronic hepatitis B virus infections in the United Kingdom: a wake-up call. Clin Infect Dis 2012; 56:951-60. [PMID: 23223601 DOI: 10.1093/cid/cis1013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Through migration, diversity of chronic hepatitis B virus (HBV) infection has changed, affecting disease burden and control. We describe clinical and viral characteristics of chronic HBV in the United Kingdom. METHODS A total of 698 individuals with chronic HBV infection were recruited from referral liver centers. Demographic, clinical, and laboratory data were collected. RESULTS Sixty-one percent of patients were male, 80% were not born in the United Kingdom, and the largest ethnicity was East/Southeast Asian (36%). Twenty-two percent were hepatitis B e antigen (HBeAg) seropositive; 20.4% (59/289) had cirrhosis and 10 (1.7%) had hepatocellular carcinoma. Genotype D was most common (31%) followed by A, C, B, and E (20%, 20%, 19%, and 9%, respectively). Genotype was significantly associated with country of birth, length of time in the United Kingdom, HBeAg status, and precore and basal core promoter mutations. One-third were on treatment, with men independently more likely to be treated. Only 18% of those on treatment were on recommended first-line therapies, and 30% were on lamivudine monotherapy. Among treated individuals, 27% had antiviral drug resistance. Testing rates for human immunodeficiency virus, hepatitis C virus, and delta coinfections were low. CONCLUSIONS We demonstrated diversity of chronic HBV infections in UK patients, suggesting that optimal management requires awareness of the variable patterns of chronic HBV in countries of origin. We also found less-than-optimal clinical management practices, possible gender-based treatment bias, and the need to improve testing for coinfections.
Collapse
Affiliation(s)
- Richard S Tedder
- Microbiology Services-Colindale, Health Protection Agency, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Ijaz S, Szypulska R, Andrews N, Tedder RS. Investigating the impact of hepatitis B virus surface gene polymorphism on antigenicity using ex vivo phenotyping. J Gen Virol 2012; 93:2473-2479. [DOI: 10.1099/vir.0.044305-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The hepatitis B virus (HBV) surface antigen (HBsAg) is a complex protein, and understanding accurately the impact of amino acid changes on the antigenicity of the immunodominant a determinant must take this complexity into consideration. Epitope mapping with four mAbs was used to phenotype HBsAg directly from patients’ sera to investigate the effect of mutations in their native genetic backbone. The expected mAb reactivity was established initially for samples harbouring ‘wild-type’ HBsAg sequences across genotypes A–E. The alteration of HBsAg antigenicity, defined by mAb epitope loss, was demonstrated in a number of samples with sequence-inferred amino acid changes. Individual mutations within the mapped epitopes to which the mAbs were directed usually affected their binding. However, the loss of more than one epitope was observed as the number of mutations within a sequence increased. Conversely, not all mutations occurring in the a determinant altered the HBsAg conformation. The genotype backbone, the specific amino acid substitution and amino acid changes occurring outside the major antigenic region appeared to be important in determining expression of the predicted epitope loss. These data clearly demonstrate that sequence-based methods alone may not accurately define HBsAg phenotype. This phenotyping methodology allows for the rapid and accurate identification of antigenically altered viruses and will greatly enhance current HBV surveillance, research and diagnostic activities. The data generated can be used to inform on public health issues relating to prevalence, transmission and impact of HBsAg mutants in HBV-infected populations.
Collapse
Affiliation(s)
- Samreen Ijaz
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Renata Szypulska
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Nick Andrews
- Statistics, Modelling and Economics Department, Health Protection Services-Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Richard S. Tedder
- Division of Infection and Immunity, University College London, Gower Street, London WC1E 6BT, UK
- Transfusion Microbiology, NHS Blood and Transplant, Colindale Avenue, London NW9 5BG, UK
- Blood Borne Virus Unit, Virus Reference Department, Microbiology Services-Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| |
Collapse
|
50
|
Winchester SA, Tedder RS, Pomplun S, Sudhanva M, Zuckerman M, Poulton M, Devereux S, Schey S. Lymphadenopathy and splenomegaly in an HIV-infected man. J Clin Virol 2012; 56:181-4. [PMID: 22939364 DOI: 10.1016/j.jcv.2012.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 08/03/2012] [Indexed: 11/16/2022]
Affiliation(s)
- S A Winchester
- South London Specialist Virology Centre, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom.
| | | | | | | | | | | | | | | |
Collapse
|