Previous dengue or Zika virus exposure can drive to infection enhancement or neutralisation of other flaviviruses

Abstract

BACKGROUND Dengue virus (DENV) has circulated in Brazil for over 30 years. During this time, one serotype has cyclically replaced the other, until recently, when all four distinct serotypes began to circulate together. Persistent circulation of DENV for long time periods makes sequential infections throughout a person's life possible. After primary DENV infection, lifelong immunity is developed for the infecting serotype. Since DENV and Zika virus (ZIKV) are antigenically similar, the possibility of cross-reactions has attracted attention and has been demonstrated in vitro. OBJECTIVE The aim of this study was to investigate whether immune-sera from DENV and ZIKV infected patients would crossreact in vitro with other Flaviviridae family members. METHODS Cross-reaction of the studied samples with yellow fever virus (YFV), West Nile virus (WNV), Rocio virus (ROCV), Saint Louis virus (SLEV) and Ilheus virus (ILHV) has been investigated by plaque reduction neutralisation test (PRNT) and the antibody-dependent enhancement (ADE) by flow-cytometry. FINDINGS Antibodies against ZIKV and DENV virus cross-reacted with other flaviviruses either neutralising or enhancing the infection. Thus, viral entrance into FcRFcɣRII-expressing cells were influenced by the cross-reactive antibodies. ZIKV or DENV immune sera enhanced cellular infection by WNV, ILHV, ROCV and SLEV. Finally, DENV immune sera presented higher neutralising activity for YFV and SLEV. While ZIKV immune sera neutralised WNV, ILHV and ROCV with high frequencies of positivity. MAIN CONCLUSIONS The co-circulation of those viruses in the same area represents a risk for the development of severe infections if they spread throughout the country. Successive flavivirus infections may have an impact on disease pathogenesis, as well as on the development of safe vaccine strategies.

Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey

“…The incidence of dengue has remained stable over the past few decades in Vietnam [27], and dengue seroprevalence remains high, with up to 64% of the adult population being seropositive [28]. Recent studies have suggested that while DENV is cross-reactive with ZIKV, the level of cross-neutralization and hence disease protection is limited [29][30][31]. In Vietnam, the number of ZIKV infections peaked at 219 in 2016, and has subsequently decreased, with only one reported case in 2019 [32].…”

Rapid decline of Zika virus NS1 antigen-specific antibody responses, northeastern Brazil

“…In contrast, Brazil has 210 million inhabitants spread over 8 million km 2 (latest United Nations Population Division estimates). In Brazil, as other Latin American countries, cocirculation of other flaviviruses such as DENV, Yellow fever virus, Bussuquara, Cacipacoré, Ilhéus, Rocio and Saint Louis encephalitis virus might elicit unique flaviviral antibody responses that impact ZIKV-specific antibody kinetics [15][16][17]. Nonetheless, longterm antibody kinetics of individuals infected with ZIKV in Brazil are largely unknown.…”

Disease Resurgence, Production Capability Issues and Safety Concerns in the Context of an Aging Population: Is There a Need for a New Yellow Fever Vaccine?

“…There are no documented cases of repeated YFV infection, even in several historical cohorts [49]. Evidence also suggests that previous heterologous flavivirus exposure, for example from prior dengue virus infection, may provide partial cross protection against severe YF [43,50,51].…”