Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.chom.2019.10.005
Title: Persistent Dengue Infection in an Immunosuppressed Patient Reveals the Roles of Humoral and Cellular Immune Responses in Virus Clearance
Authors: NG KAR HUI 
ZHANG LIXIN, SUMMER 
TAN HWEE CHENG 
Swee Sen Kwek
October Michael Sessions 
CHAN CHANG YIEN 
LIU DESHENG, ISAAC 
Chun Kiat Lee
PAUL ANANTHARAJAH TAMBYAH 
OOI ENG EONG 
YAP HUI KIM 
Issue Date: 8-Nov-2019
Publisher: Elsevier Inc.
Citation: NG KAR HUI, ZHANG LIXIN, SUMMER, TAN HWEE CHENG, Swee Sen Kwek, October Michael Sessions, CHAN CHANG YIEN, LIU DESHENG, ISAAC, Chun Kiat Lee, PAUL ANANTHARAJAH TAMBYAH, OOI ENG EONG, YAP HUI KIM (2019-11-08). Persistent Dengue Infection in an Immunosuppressed Patient Reveals the Roles of Humoral and Cellular Immune Responses in Virus Clearance 26 (5) : 601-605.e3. ScholarBank@NUS Repository. https://doi.org/10.1016/j.chom.2019.10.005
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
Abstract: Detailed understanding of the roles of humoral and cellular immune responses in sterilizing dengue virus (DENV) infection in humans is required to inform effective vaccine development. We report an unusual case of persistent DENV infection in a lymphopenic renal transplant recipient who was therapeutically immunosuppressed to prevent organ rejection. Following resolution of symptomatic dengue, this patient remained positive for DENV3 RNA in the blood for 4 months and viruric up to 9 months post-infection despite demonstrable levels of serum neutralizing antibodies throughout this period. Full resolution of DENV infection instead coincided with recovery of CD8+ T cell counts during reversal from lymphopenia. Taken collectively, our observations suggest a role for cellular immunity in sterilizing DENV infection in humans. Any dengue vaccine should thus be able to induce both humoral and cellular immunity that respectively prevent symptomatic infection and enable effective viral clearance.
URI: https://scholarbank.nus.edu.sg/handle/10635/200309
ISSN: 1931-3128
DOI: 10.1016/j.chom.2019.10.005
Rights: Attribution-NonCommercial-NoDerivatives 4.0 International
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