title: Prolonged replication of a type 1 vaccine-derived poliovirus in an immunodeficient patient.
abstract: VP1 sequences were determined for poliovirus type 1 isolates obtained over a 189-day period from a poliomyelitis patient with common variable immunodeficiency syndrome (a defect in antibody formation). The isolate from the first sample, taken 11 days after onset of paralysis, contained two poliovirus populations, differing from the Sabin 1 vaccine strain by approximately 10%, differing from diverse type 1 wild polioviruses by 19 to 24%, and differing from each other by 5.5% of nucleotides. Specimens taken after day 11 appeared to contain only one major poliovirus population. Evolution of VP1 sequences at synonymous third-codon positions occurred at an overall rate of approximately 3.4% per year over the 189-day period. Assuming this rate to be constant throughout the period of infection, the infection was calculated to have started approximately 9.3 years earlier. This estimate is about the time (6. 9 years earlier) the patient received his last oral poliovirus vaccine dose, approximately 2 years before the diagnosis of immunodeficiency. These findings may have important implications for the strategy to eliminate poliovirus immunization after global polio eradication.
authors.affiliation: Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. omk1@cdc.gov
authors.forename: O M
authors.initials: OM
authors.lastname: Kew
authors.forename: R W
authors.initials: RW
authors.lastname: Sutter
authors.forename: B K
authors.initials: BK
authors.lastname: Nottay
authors.forename: M J
authors.initials: MJ
authors.lastname: McDonough
authors.forename: D R
authors.initials: DR
authors.lastname: Prevots
authors.forename: L
authors.initials: L
authors.lastname: Quick
authors.forename: M A
authors.initials: MA
authors.lastname: Pallansch
mesh_terms: D000328:Adult; D000595:Amino Acid Sequence; D001483:Base Sequence; D002213:Capsid / Q000235:genetics; D036022:Capsid Proteins; D002648:Child; D019143:Evolution, Molecular; D005243:Feces / Q000821:virology; D005500:Follow-Up Studies; D014644:Genetic Variation; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000150:complications* / Q000276:immunology / Q000821:virology; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D011051:Poliomyelitis / Q000150:complications / Q000276:immunology* / Q000821:virology; D017955:Poliovirus / Q000145:classification* / Q000235:genetics / Q000502:physiology*; D011055:Poliovirus Vaccine, Oral; D016133:Polymerase Chain Reaction / Q000379:methods; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D016415:Sequence Alignment; D017386:Sequence Homology, Amino Acid; D010948:Viral Plaque Assay; D014779:Virus Replication
chemical_list: D036022:Capsid Proteins; D011055:Poliovirus Vaccine, Oral; D012367:RNA, Viral; C442540:VP1 protein, Poliovirus