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Clinical, serological and virological characteristics of Dengue virus serotype 2 (DENV-2) infection in a cohort previously exposed to serotype 1

Abstract

Four distinct dengue serotypes (DENV-1-4) are recognized, and Brazil is currently endemic for all. Infection by a serotype produces lasting immunity against reinfection by the same serotype, but cross-protection is temporary and partial, resulting in sequential infections. It occurs that heterotypic secondary infections appear to present a greater risk for signs of warning/severity. This risk would still be conditioned, according to some studies, with the serotypes responsible for primary and secondary infections. Although there are studies on the relationship between severity and serotypes, there are still no definitive answers. Currently, Araraquara (SP) experiences a huge epidemic of dengue mainly caused by serotype 2, and in the last 9 years it had serotype 1 as the major. From the concept that patients with secondary dengue (or post secondary) are more likely to have a worse prognosis; and that there are serotypes with greater virulence than others, we intend, based on a longitudinal analysis cohort study, to determine whether individuals previously infected with DENV-1 who acquire DENV-2 will in fact have a worse prognosis than individuals who contract infection by DENV-2. To answer this question, an existing cohort of approximately 3,500 individuals between 02-16 years old followed up during the last 4 years in the municipality of Araraquara with specific data on initial serological status (2014), seroconversion, cases of dengue infection confirmed by serological and molecular methods (with serotyping), symptomatology of the infected and clinical outcome will be prospectively followed. Based on this cohort, there will be 4 different possible scenarios: Primary -DENV-1 cases; secondary DENV-1; Primary DENV-2; and DENV-2 secondary to DENV-1. It is important to emphasize that the biggest challenge of this study would be the structuring and the build of the cohort, and this is already done and is functional thanks to a project in collaboration with the SESA started in 2014. Samples of individuals from the cohort will be collected on suspicion of dengue and sent to our group immediately. Once in the Laboratory, the samples will be submitted to molecular tests for DENV, antigen (NS1), posterior typing, and serology. The determination of primary or secondary dengue will be done through recorded data and confirmation by avidity test. New cases may also be included, respecting the cohort's age group, currently with a maximum of 19 years. PRNT tests for the 4 dengue serotypes will be included for all non-primary cases. Anti zika PRNT will also be performed for the verification of possible cross-reaction between IgG in commercial anti-denv IgG tests and also for the evaluation of the impact of past zika virus infection (and presence of anti-zika antibodies) on current dengue infection. At the end of the study, we intend to have an overview of the number of cases; cases classified as primary and secondary; serological and virological parameters, comparing always with respect to infection and serotype (1st or 2nd and whether DENV-1 or DENV-2). Virus genomes will be sequenced for potential genetic signatures associated to prognostic. Finally, in order to maintain vigilance for the entry of other arboviruses, cases that are negative for dengue will be submitted to analysis for other previously established arboviruses and, if necessary, viral metagenomics. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ROMANO, CAMILA MALTA; FELIX, ALVINA CLARA; DE PAULA, ANDERSON VICENTE; DE JESUS, JAQUELINE GOES; ANDRADE, PAMELA S.; CANDIDO, DARLAN; DE OLIVEIRA, FRANCIANE M.; RIBEIRO, ANDREIA C.; DA SILVA, FRANCINI C.; INEMAMI, MARTA; et al. SARS-CoV-2 reinfection caused by the P.1 lineage in Araraquara city, Sao Paulo State, Brazil. Revista do Instituto de Medicina Tropical de São Paulo, v. 63, . (18/14389-0, 19/03859-9, 17/13981-0, 19/24251-9)
FRANCIELLE T. G. SOUSA; CRISTINA NUNES; CAMILA MALTA ROMANO; ESTER CERDEIRA SABINO; MIGUEL ANGEL GONZÁLEZ-CARDENETE. Anti-Zika virus activity of several abietane-type ferruginol analogues. Revista do Instituto de Medicina Tropical de São Paulo, v. 62, p. -, . (19/03859-9, 13/01702-9, 13/01690-0)
BRASIL MATOS, ALINE DE MOURA; DAHY, FLAVIA ESPER; LUISI DE MOURA, JOAO VICTOR; NASCIMENTO MARCUSSO, ROSA MARIA; FERREIRA GOMES, ANDRE BORGES; MAIA CARVALHO, FERNANDA MARTINS; PERES FERNANDES, GUSTAVO BRUNIERA; FELIX, ALVINA CLARA; SMID, JERUSA; VIDAL, JOSE ERNESTO; et al. Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series. FRONTIERS IN NEUROLOGY, v. 12, . (19/03859-9, 20/05984-2)
FELIX, ALVINA C.; DE PAULA, V, ANDERSON; RIBEIRO, ANDREIA C.; DA SILVA, FRANCINI C.; INEMAMI, MARTA; COSTA, ANGELA A.; LEAL, CIBELE O. D.; FIGUEIREDO, WALTER M.; SARMENTO, DMITRY J. S.; SASSAKI, TATIANA A.; et al. Saliva as a reliable sample for COVID-19 diagnosis in paediatric patients. International Journal of Paediatric Dentistry, v. 32, n. 1, . (19/03859-9)

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