Zika virus infection enhances future risk of severe dengue disease.

Abstract

The Zika pandemic sparked intense interest in whether immune interactions among dengue virus serotypes 1 to 4 (DENV1 to -4) extend to the closely related Zika virus (ZIKV). We investigated prospective pediatric cohorts in Nicaragua that experienced sequential DENV1 to -3 (2004 to 2015), Zika (2016 to 2017), and DENV2 (2018 to 2020) epidemics. Risk of symptomatic DENV2 infection and severe disease was elevated by one prior ZIKV infection, one prior DENV infection, or one prior DENV infection followed by one ZIKV infection, compared with being flavivirus-naïve. By contrast, multiple prior DENV infections reduced dengue risk. Further, although high preexisting anti-DENV antibody titers protected against DENV1, DENV3, and ZIKV disease, intermediate titers induced by previous ZIKV or DENV infection enhanced future risk of DENV2 disease and severity, as well as DENV3 severity. The observation that prior ZIKV infection can modulate dengue disease severity like a DENV serotype poses challenges to development of dengue and Zika vaccines.

• Authors: Leah C Katzelnick, César Narvaez, Sonia Arguello, Brenda Lopez Mercado, Damaris Collado, Oscarlett Ampie, Douglas Elizondo, Tatiana Miranda, Fausto Bustos Carillo, Juan Carlos Mercado, Krista Latta, Amy Schiller, Bruno Segovia-Chumbez, Sergio Ojeda, Nery Sanchez, Miguel Plazaola, Josefina Coloma, M Elizabeth Halloran, Lakshmanane Premkumar, Aubree Gordon, Federico Narvaez, Aravinda M de Silva, Guillermina Kuan, Angel Balmaseda, Eva Harris
• Journal: Science (New York, N.Y.) (Science) Vol. 369 Issue 6507 Pg. 1123-1128 (08 28 2020) ISSN: 1095-9203 [Electronic] United States
• PMID: 32855339 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Chemical References

• Antibodies, Viral
• Dengue Vaccines

Topics

• Antibodies, Viral (blood)
• Dengue Vaccines (immunology)
• Dengue Virus (immunology)
• Humans
• Immunogenicity, Vaccine
• Nicaragua (epidemiology)
• Risk
• Serogroup
• Severe Dengue (epidemiology)
• Zika Virus (immunology)
• Zika Virus Infection (epidemiology, immunology)