Search for poliovirus long-term excretors among patients affected by agammaglobulinemia

Fiore, Lucia; Plebani, Alessandro; Buttinelli, Gabriele; Fiore, Stefano; Donati, Valentina; Marturano, Jill; Soresina, Annarosa; Martire, Baldassarre; Azzari, Chiara; Nigro, Giovanni; Cardinale, Fabio; Trizzino, Antonino; Pignata, Claudio; Alvisi, Patrizia; Anastasio, Elisa; Bossi, Grazia; Ugazio, Alberto G.

doi:10.1016/j.clim.2003.11.011

Cited by 25 publications

(20 citation statements)

References 20 publications

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“…In contrast, the exclusive B cell defect (i.e., agammaglobulinemia) was rarely associated with enterovirus excretion in this series (only 1 patient out of 11 had a nonpolio enterovirus). This has already been observed by other authors (8). All together, these data suggest that T cells play a major role in both clearance and susceptibility to enterovirus infection.…”

Section: Discussionsupporting

confidence: 73%

“…In the literature, most of the reported long-term poliovirus excreters were found mainly among PID patients with hypogammaglobulinemia and particularly CVID (5,8,12,13,15,18,20). Interestingly, herein we found that patients with combined immunodeficiencies (T and B cell defects) are at a higher risk for enterovirus infection than those with exclusively a B cell defect.…”

Section: Discussionsupporting

confidence: 48%

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High Susceptibility for Enterovirus Infection and Virus Excretion Features in Tunisian Patients with Primary Immunodeficiencies

Driss

Ben‐Mustapha

Mellouli

et al. 2012

Clin. Vaccine Immunol.

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To estimate the susceptibility to enterovirus infection and the frequency of long-term poliovirus excreters in Tunisian patients with primary immunodeficiencies (PIDs), enteroviruses were assessed in stool specimens of 82 patients with humoral, combined, and other PIDs. Isolated viruses were typed and intratyped by standard molecular techniques, and the whole VP1 region of poliovirus isolates was sequenced. Polioviruses were detected in 6 patients; all isolates were vaccine related. Five patients rapidly stopped excretion; one excreted a poliovirus type 1 isolate for several months, and the isolate accumulated up to 14 mutations in the VP1 region. Nonpolio enteroviruses were identified in 6 patients; 4 of them kept excreting the same strain for more than 6 months. The rate of enterovirus infection was 13.4% of the PID patients and 20.7% of those with an IgG defect; it greatly exceeded the rates generally found in Tunisian supposed-immunocompetent individuals (4.1% during the study period; P ‫؍‬ 0.001 and P < 0.0001, respectively). Interestingly, patients with combined immunodeficiencies were at a higher risk for enterovirus infection than those with an exclusively B cell defect. A major histocompatibility complex (MHC) class II antigen expression defect was found in 54% of enterovirus-positive patients and in the unique long-term poliovirus excreter. The study results also suggest that substitutive immunoglobulin therapy may help clearance of a poliovirus infection and that most PID patients have the ability to stop poliovirus excretion within a limited period. However, the high susceptibility of these patients to enterovirus infection reinforces the need for enhanced surveillance of these patients until the use of oral poliovirus vaccine (OPV) is stopped.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 48%

High Susceptibility for Enterovirus Infection and Virus Excretion Features in Tunisian Patients with Primary Immunodeficiencies

Driss

Ben‐Mustapha

Mellouli

et al. 2012

Clin. Vaccine Immunol.

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“…There has been no evidence of paralytic disease resulting from secondary exposure to iVDPVs; however, since most contacts of these individuals are immune, the significance of this observation is uncertain. Studies designed to search for more patients with prolonged shedding of vaccine virus show that these cases are rare [16,18]. One study has reported that a healthy child possibly shed vaccine virus for 6 months; however, this finding is not definitive, because serial sampling did not cover the entire 6-month period, and the child's mother was HIV infected [19].…”

mentioning

confidence: 99%

Poliovirus Vaccine Shedding among Persons with HIV in Abidjan, Cote d’Ivoire

Hennessey¹,

Lago²,

Diomandé³

et al. 2005

J INFECT DIS

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“…Nineteen individuals with poliovirus excretion for >6 months are known to the World Health Organization [77]. Nonetheless, others did not find prolonged VDPV shedding in a cohort of 38 X-linked agammaglobulinemia (XLA) patients [78], 16 PID patients [79], and 346 IgG-or IgA-deficient patients [77], suggesting that these chronic carriers are incidental cases. In HIV-positive individuals, who predominantly have T cell defects but may develop humoral deficits, prolonged VDPV shedding (>6 months) has not been reported [67][68][69][80][81][82], except for one study in which person-to-person transmission however could not be excluded [68,69].…”

Section: Enterovirusmentioning

confidence: 99%

The Role of Prolonged Viral Gastrointestinal Infections in the Development of Immunodeficiency-Related Enteropathy

Ven

Konijnenburg

Wensing

et al. 2011

Clinic Rev Allerg Immunol

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Patients with primary immunodeficiencies are prone to develop enteropathy of unknown pathogenesis. We hypothesize that ineffective clearance of gastrointestinal pathogens, particularly viruses, in combination with defective immune regulation may cause inflammatory enteropathy in certain immunodeficient hosts. We reviewed publications related to prolonged enteric viral infection, immunodeficiency, and the subsequent development of inflammatory enteropathy. Prolonged infection with especially enteroviral infections was reported more often in immunocompromised hosts than in healthy individuals. Protracted enteric viral shedding was not always associated with the presence or duration of gastrointestinal symptoms. The development of immunodeficiencyassociated enteropathy after prolonged viral infections was described in sporadic cases. Clinical consequences of viral gut infections in immunocompromised hosts comprise isolation issues and supportive care. Prospective studies in cohorts of immunodeficient patients are required to study the impact of prolonged enteric viral replication with respect to the pathogenesis of non-infectious enteropathy.

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Search for poliovirus long-term excretors among patients affected by agammaglobulinemia

Cited by 25 publications

References 20 publications

High Susceptibility for Enterovirus Infection and Virus Excretion Features in Tunisian Patients with Primary Immunodeficiencies

High Susceptibility for Enterovirus Infection and Virus Excretion Features in Tunisian Patients with Primary Immunodeficiencies

Poliovirus Vaccine Shedding among Persons with HIV in Abidjan, Cote d’Ivoire

The Role of Prolonged Viral Gastrointestinal Infections in the Development of Immunodeficiency-Related Enteropathy

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