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ZIKA Virus Neutralizing Antibody Kinetics in Antenatally Exposed Infants
Otavio de Melo Espindola1, Thomas Jaenisch2,3,4,5, Karin Nielsen-Saines6
1Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
The Journal of Infectious Diseases
|February 2, 2021
Summary
Infants exposed to Zika virus (ZIKV) in utero do not develop protective ZIKV neutralizing antibodies (nAb) despite an early IgM response. Virus neutralization tests are not useful for diagnosing congenital ZIKV infection in children.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Zika virus (ZIKV) causes severe congenital abnormalities.
- Diagnosing antenatal ZIKV infection is challenging.
- This study examines ZIKV neutralizing antibody (nAb) kinetics in infants born to mothers with ZIKV infection during pregnancy.
Purpose of the Study:
- To evaluate ZIKV nAb kinetics in infants born to mothers with PCR-confirmed ZIKV infection during pregnancy.
- To assess the utility of ZIKV virus neutralization test (VNT) for diagnosing congenital ZIKV infection.
Main Methods:
- Serum specimens from 98 neonates were repeatedly tested for ZIKV nAb over 2 years using VNT.
- Neonatal ZIKV infection was confirmed by RT-PCR and/or ZIKV IgM antibodies.
- Infant clinical features were correlated with infection status.
Main Results:
- 60.2% of infants showed evidence of ZIKV vertical transmission.
- 32.7% of infants exhibited clinical abnormalities.
- ZIKV nAb levels generally declined, reflecting maternal antibody decay, despite an early IgM response in some infants.
Conclusions:
- Infants with antenatal ZIKV exposure do not develop ZIKV nAb, even with an early IgM response.
- ZIKV VNT is not a reliable diagnostic tool for congenital ZIKV infection in children.
- Further research is needed to determine if in utero ZIKV-infected children are susceptible to reinfection.
