Decay and Persistence of Maternal Dengue Antibodies among Infants in Bangkok

Abstract

Maternal dengue antibodies are important in determining the optimal age of dengue vaccination, but no study has quantified the heterogeneity of antibody decay and persistence in infants. We used longitudinal regression methods and survival analysis to measure decay and persistence times of serotype-specific neutralizing antibodies in 139 infants in Bangkok. A biphasic decay pattern was found with half-life times of 24–29 days between birth and 3 months and 44–150 days after 3 months. Atypical decay rates were found in 17% of infants for dengue virus-1 and -4. Median persistence times of plaque reduction neutralization tests > 10 ranged from 6 to 9 months. Persistence times for individuals could not be predicted based on antibody values at birth. Vaccination against dengue before 12 months of age would be ineffective if maternal antibodies at plaque reduction neutralization test levels below 80 interfere with vaccine uptake. Projections of average antibody persistence based on values at birth should be avoided in studies on dengue pathogenesis in infants.

Analysis of the optimal vaccination age for dengue in Brazil with a tetravalent dengue vaccine

“…1 − C(a) represents the fraction of a cohort of individuals who were initially entirely protected by maternal antibodies at birth who are still protected at age a. These proportions are estimated from data on the decline of maternal antibodies for each of the four serotypes given in van Panhuis et al [32]. Therefore passive immunes and susceptibles are given by (1 − C(a)) U H (a, t) and C(a)U H (a, t) respectively.…”

Incidencia de Dengue Grave en lactantes

“…La hipótesis de la persistencia de anticuerpos maternos IgG subneutralizantes para el virus del dengue provenientes de madres sensibilizadas previamente, se ha postulado en la patogénesis de enfermedad severa en niños pequeños por el efecto (6)(7)(8)(9) ADE (antibody-dependentenhancement) . Varios estudios afirman que los anticuerpos maternos son detectados en menos del 50% de los lactantes menores de 6 meses de edad y que son prácticamente indetectables al cumplir éstos 12 (15)(16)(17) meses de edad .…”

“…En regiones de endemicidad de la enfermedad han establecido que el pico de incidencia de dengue grave ocurre entre el 6º y 8º mes de vida, cuando el (9) niño adquiere la infección primaria . En una cohorte prospectiva en Filipinas, durante 3 años incluyeron 353 niños menores de 1 año y determinaron una incidencia de Dengue Grave de 0.5/1000 habitantes con un pico entre los 3-8 meses de edad (mediana: 5,7).…”

“…Estas guías están basadas en que la persistencia de los anticuerpos maternos en los lactantes de madres previamente sensibilizadas, aumentaría el riesgo de (6)(7)(8)(9) desarrollar formas graves de la enfermedad .…”

Designing a vaccination strategy against dengue

“…Figure 3 shows the vaccine seroconversion function C(a). This function takes into account two factors: the protection conferred by maternal antibodies that lasting on average five to nine months according to the serotype 16 and the immune response observed after vaccination, quite similar for children between two to five years of age and older children 3,6 . As a consequence we considered that the seroconversion rate plateaus from two years of age.…”