ZIKA Virus Neutralizing Antibody Kinetics in Antenatally Exposed Infants
Abstract Background Zika virus (ZIKV) is associated with severe congenital abnormalities and laboratory diagnosis of antenatal infection is difficult. Here we evaluated ZIKV neutralizing antibody (nAb) kinetics in infants born to mothers with PCR-confirmed ZIKV infection during pregnancy. Methods Ne...
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Veröffentlicht in: | The Journal of infectious diseases 2021-09, Vol.224 (6), p.1060-1068 |
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Sprache: | eng |
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Zusammenfassung: | Abstract
Background
Zika virus (ZIKV) is associated with severe congenital abnormalities and laboratory diagnosis of antenatal infection is difficult. Here we evaluated ZIKV neutralizing antibody (nAb) kinetics in infants born to mothers with PCR-confirmed ZIKV infection during pregnancy.
Methods
Neonates (n = 98) had serum specimens tested repeatedly for ZIKV nAb over the first 2 years of life using virus neutralization test (VNT). ZIKV neonatal infection was confirmed by RT-PCR in blood or urine and/or presence of ZIKV IgM antibodies, and results were correlated with infant clinical features.
Results
Postnatal laboratory evidence of ZIKV vertical transmission was obtained for 60.2% of children, while 32.7% exhibited clinical abnormalities. Congenital abnormalities were found in 37.3% of children with confirmed ZIKV infection and 31.0% of children without confirmed infection (P = .734). All but 1 child displayed a physiologic decline in ZIKV nAb, reflecting maternal antibody decay, despite an early ZIKV-IgM response in one-third of infants.
Conclusions
Infants with antenatal ZIKV exposure do not develop ZIKV nAb despite an early IgM response. Therefore, ZIKV VNT in children is not useful for diagnosis of congenital infection. In light of these findings, it remains to be determined if children infected in utero are potentially susceptible to reinfection.
Infants with in utero ZIKV exposure do not develop an autochthonous production of anti-ZIKV IgG neutralizing antibodies, even those with confirmed vertical transmission by detection of ZIKV RNA or an early IgM response. |
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ISSN: | 0022-1899 1537-6613 |
DOI: | 10.1093/infdis/jiab054 |