Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru.
BACKGROUND:Nearly half of the world's population is at risk for dengue, yet no licensed vaccine or anti-viral drug is currently available. Dengue is caused by any of four dengue virus serotypes (DENV-1 through DENV-4), and infection by a DENV serotype is assumed to provide life-long protection...
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ftdoajarticles:oai:doaj.org/article:5c33c8dd339847aa85056dc5e3fd4693 2023-05-15T15:12:02+02:00 Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. Brett M Forshey Robert C Reiner Sandra Olkowski Amy C Morrison Angelica Espinoza Kanya C Long Stalin Vilcarromero Wilma Casanova Helen J Wearing Eric S Halsey Tadeusz J Kochel Thomas W Scott Steven T Stoddard 2016-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004398 https://doaj.org/article/5c33c8dd339847aa85056dc5e3fd4693 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4746126?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004398 https://doaj.org/article/5c33c8dd339847aa85056dc5e3fd4693 PLoS Neglected Tropical Diseases, Vol 10, Iss 2, p e0004398 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004398 2022-12-31T03:01:29Z BACKGROUND:Nearly half of the world's population is at risk for dengue, yet no licensed vaccine or anti-viral drug is currently available. Dengue is caused by any of four dengue virus serotypes (DENV-1 through DENV-4), and infection by a DENV serotype is assumed to provide life-long protection against re-infection by that serotype. We investigated the validity of this fundamental assumption during a large dengue epidemic caused by DENV-2 in Iquitos, Peru, in 2010-2011, 15 years after the first outbreak of DENV-2 in the region. METHODOLOGY/PRINCIPAL FINDINGS:We estimated the age-dependent prevalence of serotype-specific DENV antibodies from longitudinal cohort studies conducted between 1993 and 2010. During the 2010-2011 epidemic, active dengue cases were identified through active community- and clinic-based febrile surveillance studies, and acute inapparent DENV infections were identified through contact tracing studies. Based on the age-specific prevalence of DENV-2 neutralizing antibodies, the age distribution of DENV-2 cases was markedly older than expected. Homologous protection was estimated at 35.1% (95% confidence interval: 0%-65.2%). At the individual level, pre-existing DENV-2 antibodies were associated with an incomplete reduction in the frequency of symptoms. Among dengue cases, 43% (26/66) exhibited elevated DENV-2 neutralizing antibody titers for years prior to infection, compared with 76% (13/17) of inapparent infections (age-adjusted odds ratio: 4.2; 95% confidence interval: 1.1-17.7). CONCLUSIONS/SIGNIFICANCE:Our data indicate that protection from homologous DENV re-infection may be incomplete in some circumstances, which provides context for the limited vaccine efficacy against DENV-2 in recent trials. Further studies are warranted to confirm this phenomenon and to evaluate the potential role of incomplete homologous protection in DENV transmission dynamics. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 2 e0004398 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Brett M Forshey Robert C Reiner Sandra Olkowski Amy C Morrison Angelica Espinoza Kanya C Long Stalin Vilcarromero Wilma Casanova Helen J Wearing Eric S Halsey Tadeusz J Kochel Thomas W Scott Steven T Stoddard Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Nearly half of the world's population is at risk for dengue, yet no licensed vaccine or anti-viral drug is currently available. Dengue is caused by any of four dengue virus serotypes (DENV-1 through DENV-4), and infection by a DENV serotype is assumed to provide life-long protection against re-infection by that serotype. We investigated the validity of this fundamental assumption during a large dengue epidemic caused by DENV-2 in Iquitos, Peru, in 2010-2011, 15 years after the first outbreak of DENV-2 in the region. METHODOLOGY/PRINCIPAL FINDINGS:We estimated the age-dependent prevalence of serotype-specific DENV antibodies from longitudinal cohort studies conducted between 1993 and 2010. During the 2010-2011 epidemic, active dengue cases were identified through active community- and clinic-based febrile surveillance studies, and acute inapparent DENV infections were identified through contact tracing studies. Based on the age-specific prevalence of DENV-2 neutralizing antibodies, the age distribution of DENV-2 cases was markedly older than expected. Homologous protection was estimated at 35.1% (95% confidence interval: 0%-65.2%). At the individual level, pre-existing DENV-2 antibodies were associated with an incomplete reduction in the frequency of symptoms. Among dengue cases, 43% (26/66) exhibited elevated DENV-2 neutralizing antibody titers for years prior to infection, compared with 76% (13/17) of inapparent infections (age-adjusted odds ratio: 4.2; 95% confidence interval: 1.1-17.7). CONCLUSIONS/SIGNIFICANCE:Our data indicate that protection from homologous DENV re-infection may be incomplete in some circumstances, which provides context for the limited vaccine efficacy against DENV-2 in recent trials. Further studies are warranted to confirm this phenomenon and to evaluate the potential role of incomplete homologous protection in DENV transmission dynamics. |
format |
Article in Journal/Newspaper |
author |
Brett M Forshey Robert C Reiner Sandra Olkowski Amy C Morrison Angelica Espinoza Kanya C Long Stalin Vilcarromero Wilma Casanova Helen J Wearing Eric S Halsey Tadeusz J Kochel Thomas W Scott Steven T Stoddard |
author_facet |
Brett M Forshey Robert C Reiner Sandra Olkowski Amy C Morrison Angelica Espinoza Kanya C Long Stalin Vilcarromero Wilma Casanova Helen J Wearing Eric S Halsey Tadeusz J Kochel Thomas W Scott Steven T Stoddard |
author_sort |
Brett M Forshey |
title |
Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
title_short |
Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
title_full |
Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
title_fullStr |
Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
title_full_unstemmed |
Incomplete Protection against Dengue Virus Type 2 Re-infection in Peru. |
title_sort |
incomplete protection against dengue virus type 2 re-infection in peru. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004398 https://doaj.org/article/5c33c8dd339847aa85056dc5e3fd4693 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 2, p e0004398 (2016) |
op_relation |
http://europepmc.org/articles/PMC4746126?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004398 https://doaj.org/article/5c33c8dd339847aa85056dc5e3fd4693 |
op_doi |
https://doi.org/10.1371/journal.pntd.0004398 |
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PLOS Neglected Tropical Diseases |
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10 |
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2 |
container_start_page |
e0004398 |
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