慢性和重新激活的登革热感染在免疫受损宿主:从病例报告的见解
Ludovic Di Ascia1,2, Etienne Frumence3,4, Nicolas Traversier5,6
1Service de Néphrologie, CHU Réunion Site Nord, Saint-Denis, Réunion, France.
Tropical medicine and health
|August 15, 2025
概括
这项案例研究揭示了免疫功能低下的患者患有慢性登革热感染,相同的登革热病毒菌株持续近三年. 这挑战了登革热仅仅是急性疾病的观点,并突出了免疫功能受损的个体面临的风险.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 登革热病毒 (DENV) 感染是一个重要的全球卫生问题,流行率不断增加.
- 虽然登革热通常是急性,但在免疫力低下的人群中可能会持续存在.
研究的目的:
- 报告一种罕见的慢性登革热感染病例.
- 在免疫功能低下的患者中调查病毒的持久性和活性.
主要方法:
- 一个43岁的女性患有狼性炎和末期脏疾病的案例研究.
- 在最初感染后的32-34个月内检测登革热RNA.
- 基因组分析以确认病毒菌株的持久性.
主要成果:
- 症状性登革热的重新激活发生在最初感染后近三年.
- 同一个DENV-1菌株持续存在,表明慢性感染,而不是再感染.
- 免疫抑制疗法 (包括rituximab) 可能导致病毒持久性.
结论:
- 这一案例证明了在免疫功能低下的患者中慢性登革热感染的可能性.
- 持续的登革热菌株挑战了急性感染模式,并引发了人们对再次出现的担忧.
- 这些发现影响了登革热的临床管理,诊断和监测,强调了对病毒免疫逃避和宿主功能障碍的研究.
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