title: Vaccine-Derived Polioviruses and Children with Primary Immunodeficiency, Iran, 1995-2014.
abstract: Widespread use of oral poliovirus vaccine has led to an ≈99.9% decrease in global incidence of poliomyelitis (from ≈350,000 cases in 1988 to 74 cases in 2015) and eradication of wild-type poliovirus serotypes 2 and 3. However, patients with primary immunodeficiency might shed vaccine-derived polioviruses (VDPVs) for an extended period, which could pose a major threat to polio eradication programs. Since 1995, sixteen VDPV populations have been isolated from 14 patients with immunodeficiency in Iran. For these patients, vaccine-associated paralysis, mostly in >1 extremity, was the first manifestation of primary immunodeficiency. Seven patients with humoral immunodeficiency cleared VDPV infection more frequently than did 6 patients with combined immunodeficiencies. Our results raise questions about manifestations of VDPVs in immunodeficient patients and the role of cellular immunity against enterovirus infections. On the basis of an association between VDPVs and immunodeficiency, we advocate screening of patients with primary immunodeficiency for shedding of polioviruses.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Shaghaghi
authors.forename: Shohreh
authors.initials: S
authors.lastname: Shahmahmoodi
authors.forename: Hassan
authors.initials: H
authors.lastname: Abolhassani
authors.forename: Saeed
authors.initials: S
authors.lastname: Soleyman-Jahi
authors.forename: Leila
authors.initials: L
authors.lastname: Parvaneh
authors.forename: Sussan
authors.initials: S
authors.lastname: Mahmoudi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Chavoshzadeh
authors.forename: Reza
authors.initials: R
authors.lastname: Yazdani
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Zahraei
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ebrahimi
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Eslamian
authors.forename: Hamideh
authors.initials: H
authors.lastname: Tabatabaie
authors.forename: Maryam
authors.initials: M
authors.lastname: Yousefi
authors.forename: Yaghoob M
authors.initials: YM
authors.lastname: Kandelousi
authors.forename: Aliasghar
authors.initials: A
authors.lastname: Oujaghlou
authors.forename: Nima
authors.initials: N
authors.lastname: Rezaei
authors.forename: Asghar
authors.initials: A
authors.lastname: Aghamohammadi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005243:Feces / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000276:immunology* / Q000821:virology; D007492:Iran; D008297:Male; D011051:Poliomyelitis / Q000209:etiology / Q000276:immunology* / Q000401:mortality / Q000821:virology; D017955:Poliovirus / Q000276:immunology / Q000302:isolation & purification*; D011054:Poliovirus Vaccine, Inactivated / Q000009:adverse effects / Q000276:immunology*; D011055:Poliovirus Vaccine, Oral / Q000009:adverse effects / Q000276:immunology*; D016896:Treatment Outcome; D017201:Virus Shedding / Q000276:immunology*; D055815:Young Adult
chemical_list: D011054:Poliovirus Vaccine, Inactivated; D011055:Poliovirus Vaccine, Oral
keywords: Iran; children; polio; poliomyelitis; poliovirus; primary immunodeficiency; vaccination; vaccine-derived poliovirus; viruses