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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
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Neonatal enterovirus infection: virology, serology, and effects of intravenous immune globulin

M J Abzug1, H L Keyserling, M L Lee

  • 1Department of Pediatrics (Infectious Diseases), University of Colorado School of Medicine/Children's Hospital, Denver 80218, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 1, 1995
PubMed

Insights

Neonatal enterovirus infection can be serious, with many infants lacking protective antibodies. Intravenous immune globulin (IVIG) showed modest benefits, but IVIG with high antibody titers against the specific virus improved outcomes.

Area of Science:

  • Virology
  • Immunology
  • Neonatal Medicine

Background:

  • Enterovirus infections pose significant risks to neonates, often presenting without detectable neutralizing antibodies.
  • Maternal antibodies may not always confer protection against neonatal enterovirus infection.
  • Viremia and viruria are common in neonates with enterovirus infections.

Purpose of the Study:

  • To investigate the virology and serological responses to enterovirus infection in neonates.
  • To evaluate the efficacy of intravenous immune globulin (IVIG) in treating neonatal enterovirus disease.

Main Methods:

  • Prospective study of 16 neonates and their mothers.
  • Detection of viral isolates, viremia, and viruria.
  • Administration of IVIG (750 mg/kg) to a subset of neonates.

Main Results:

  • 11 neonates lacked detectable neutralizing antibodies to their own viral isolates.
  • Viremia and viruria were detected in 8 and 7 neonates, respectively.
  • IVIG modestly increased serum neutralization titers but did not reduce viremia/viruria incidence.
  • IVIG with high specific antibody titers (> or = 1:800) correlated with higher titers and faster viral clearance.

Conclusions:

  • Neonatal enterovirus infections highlight the vulnerability of newborns lacking specific antibodies.
  • Standard IVIG doses showed limited impact on viral shedding.
  • Future research should explore higher or repeated IVIG doses and serotype-specific IVIG for improved efficacy.

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