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High frequency of pre-existing neutralizing antibody responses in patients with dengue during an outbreak in Central Brazil.

High frequency of pre-existing neutralizing antibody responses in patients with dengue during an outbreak in Central Brazil.
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de Teive E Argolo AF, de Rezende Féres VC, Cordeiro MT, da Silveira LA, Guilarde AO, de Azevedo Marques ET, de Souza WV, Martelli CM,


de Teive E Argolo AF, de Rezende Féres VC, Cordeiro MT, da Silveira LA, Guilarde AO, de Azevedo Marques ET, de Souza WV, Martelli CM, (click to view)

de Teive E Argolo AF, de Rezende Féres VC, Cordeiro MT, da Silveira LA, Guilarde AO, de Azevedo Marques ET, de Souza WV, Martelli CM,

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BMC infectious diseases 2016 Oct 716(1) 546
Abstract
BACKGROUND
This study aims to identify dengue neutralizing antibody response in patients with dengue from a well-characterized cohort during an outbreak in central Brazil, 2012-2013.

METHODS
We analyzed paired samples from 40 patients with severe dengue and 20 patients with dengue. Eligibility criteria were: IgM, NS1Ag and/or RT-PCR positivity and positive IgG result. Plaque reduction neutralization test (PRNT50) from DENV-1 to DENV-4 was performed to identify serotype-specific NAbs response. An infecting serotype was defined as ≥4-fold increase in DENV NAbs in paired samples. Monotypic response was classified as PRNT50 ≥ 1/20 to only one DENV serotype, and multitypic response was considered to be PRNT50 ≥ 1/20 to two or more serotypes simultaneously.

RESULTS
Patients were mainly adults. Virological dengue infection was confirmed by RT-PCR: DENV-4(n = 14) and DENV-1(n = 10). Forty-four out of 60(73.3 %) patients had NAbs to DENV-4, DENV-1(68.3 %), DENV-2(68.3 %) and DENV-3(61.6 %) respectively. Fifteen percent of the cases presented monotypic response, whereas 85 % had multitypic response. DENV-4 infected-patients presented the greatest difference in PRNT50 titers compared with other serotypes. Pre-existing DENV NAbs was not correlated with disease severity. This was the first time that DENV-4 was implicated in an epidemic in the region.

CONCLUSION
Our data indicates high exposure of multiple DENV serotypes in all age groups in the pre-dengue vaccine era and also previous to Zika virus introduction in Brazil.

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