Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus

Background. Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses. Methods. Acute-phase serum samples from 346 patients...

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Autores principales: Waggoner, Jesse J., Gresh, Lionel, Vargas, Maria Jose, Ballesteros, Gabriela, Tellez, Yolanda, Soda, K. James, Sahoo, Malaya K., Nuñez, Andrea, Balmaseda, Angel, Harris, Eva, Pinsky, Benjamin A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146717/
https://www.ncbi.nlm.nih.gov/pubmed/27578819
http://dx.doi.org/10.1093/cid/ciw589
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author Waggoner, Jesse J.
Gresh, Lionel
Vargas, Maria Jose
Ballesteros, Gabriela
Tellez, Yolanda
Soda, K. James
Sahoo, Malaya K.
Nuñez, Andrea
Balmaseda, Angel
Harris, Eva
Pinsky, Benjamin A.
author_facet Waggoner, Jesse J.
Gresh, Lionel
Vargas, Maria Jose
Ballesteros, Gabriela
Tellez, Yolanda
Soda, K. James
Sahoo, Malaya K.
Nuñez, Andrea
Balmaseda, Angel
Harris, Eva
Pinsky, Benjamin A.
author_sort Waggoner, Jesse J.
collection PubMed
description Background. Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses. Methods. Acute-phase serum samples from 346 patients with a suspected arboviral illness were tested using a multiplex real-time reverse-transcription polymerase chain reaction for ZIKV, CHIKV, and DENV. Viremia was quantitated for each detected virus, and clinical information from request forms submitted with each sample was recorded. Results. A total of 263 patients tested positive for 1 or more viruses: 192 patients tested positive for a single virus (monoinfections) and 71 patients tested positive for 2 or all 3 viruses (coinfections). Quantifiable viremia was lower in ZIKV infections compared with CHIKV or DENV (mean 4.70 vs 6.42 and 5.84 log(10) copies/mL serum, respectively; P < .001 for both comparisons), and for each virus, mean viremia was significantly lower in coinfections than in monoinfections. Compared with patients with CHIKV or DENV, ZIKV patients were more likely to have a rash (P < .001) and less likely to be febrile (P < .05) or require hospitalization (P < .001). Among all patients, hospitalized cases had higher viremia than those who did not require hospitalization (7.1 vs 4.1 log10 copies/mL serum, respectively; P < .001). Conclusions. ZIKV, CHIKV, and DENV result in similar clinical presentations, and coinfections may be relatively common. Our findings illustrate the need for accurate, multiplex diagnostics for patient care and epidemiologic surveillance.
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spelling pubmed-51467172016-12-12 Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus Waggoner, Jesse J. Gresh, Lionel Vargas, Maria Jose Ballesteros, Gabriela Tellez, Yolanda Soda, K. James Sahoo, Malaya K. Nuñez, Andrea Balmaseda, Angel Harris, Eva Pinsky, Benjamin A. Clin Infect Dis Articles and Commentaries Background. Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses. Methods. Acute-phase serum samples from 346 patients with a suspected arboviral illness were tested using a multiplex real-time reverse-transcription polymerase chain reaction for ZIKV, CHIKV, and DENV. Viremia was quantitated for each detected virus, and clinical information from request forms submitted with each sample was recorded. Results. A total of 263 patients tested positive for 1 or more viruses: 192 patients tested positive for a single virus (monoinfections) and 71 patients tested positive for 2 or all 3 viruses (coinfections). Quantifiable viremia was lower in ZIKV infections compared with CHIKV or DENV (mean 4.70 vs 6.42 and 5.84 log(10) copies/mL serum, respectively; P < .001 for both comparisons), and for each virus, mean viremia was significantly lower in coinfections than in monoinfections. Compared with patients with CHIKV or DENV, ZIKV patients were more likely to have a rash (P < .001) and less likely to be febrile (P < .05) or require hospitalization (P < .001). Among all patients, hospitalized cases had higher viremia than those who did not require hospitalization (7.1 vs 4.1 log10 copies/mL serum, respectively; P < .001). Conclusions. ZIKV, CHIKV, and DENV result in similar clinical presentations, and coinfections may be relatively common. Our findings illustrate the need for accurate, multiplex diagnostics for patient care and epidemiologic surveillance. Oxford University Press 2016-12-15 2016-08-30 /pmc/articles/PMC5146717/ /pubmed/27578819 http://dx.doi.org/10.1093/cid/ciw589 Text en © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, contact journals.permissions@oup.com.
spellingShingle Articles and Commentaries
Waggoner, Jesse J.
Gresh, Lionel
Vargas, Maria Jose
Ballesteros, Gabriela
Tellez, Yolanda
Soda, K. James
Sahoo, Malaya K.
Nuñez, Andrea
Balmaseda, Angel
Harris, Eva
Pinsky, Benjamin A.
Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title_full Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title_fullStr Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title_full_unstemmed Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title_short Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus
title_sort viremia and clinical presentation in nicaraguan patients infected with zika virus, chikungunya virus, and dengue virus
topic Articles and Commentaries
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146717/
https://www.ncbi.nlm.nih.gov/pubmed/27578819
http://dx.doi.org/10.1093/cid/ciw589
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