title: Maternal antibody and viral factors in the pathogenesis of dengue virus in infants.
abstract: The pathogenesis of dengue in infants is poorly understood. We postulated that dengue severity in infants would be positively associated with markers of viral burden and that maternally derived, neutralizing anti-dengue antibody would have decayed before the age at which infants with dengue presented to the hospital. In 75 Vietnamese infants with primary dengue, we found significant heterogeneity in viremia and NS1 antigenemia at hospital presentation, and these factors were independent of disease grade or continuous measures of disease severity. Neutralizing antibody titers, predicted in each infant at the time of their illness, suggested that the majority of infants (65%) experienced dengue hemorrhagic fever when the maternally derived neutralizing antibody titer had declined to <1 : 20. Collectively, these data have important implications for dengue vaccine research because they suggest that viral burden may not solely explain severe dengue in infants and that neutralizing antibody is a reasonable but not absolute marker of protective immunity in infants.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. camsimmons1@gmail.com
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
authors.forename: Tran Nguyen Bich
authors.initials: TN
authors.lastname: Chau
authors.forename: Tran Thi
authors.initials: TT
authors.lastname: Thuy
authors.forename: Nguyen Minh
authors.initials: NM
authors.lastname: Tuan
authors.forename: Dang Minh
authors.initials: DM
authors.lastname: Hoang
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Thien
authors.forename: Le Bich
authors.initials: le B
authors.lastname: Lien
authors.forename: Nguyen Thien
authors.initials: NT
authors.lastname: Quy
authors.forename: Nguyen Trong
authors.initials: NT
authors.lastname: Hieu
authors.forename: Tran Tinh
authors.initials: TT
authors.lastname: Hien
authors.forename: Catriona
authors.initials: C
authors.lastname: McElnea
authors.forename: Paul
authors.initials: P
authors.lastname: Young
authors.forename: Steve
authors.initials: S
authors.lastname: Whitehead
authors.forename: Nguyen Thanh
authors.initials: NT
authors.lastname: Hung
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
mesh_terms: D000914:Antibodies, Viral; D000956:Antigens, Viral / Q000097:blood; D003715:Dengue / Q000276:immunology*; D003716:Dengue Virus / Q000145:classification* / Q000276:immunology; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007223:Infant; D008297:Male; D009500:Neutralization Tests; D013997:Time Factors; D019562:Viral Load
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral