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Serological inference of past primary and secondary dengue infection: implications for vaccination. | LitMetric

AI Article Synopsis

  • The World Health Organization recommends screening for serostatus before administering the Dengvaxia vaccine due to increased risks for seronegative recipients.
  • This study estimates the annual force of infection (FOI) for dengue in three locations in Vietnam, revealing different transmission intensities based on age groups.
  • It identifies that a quantitative approach to measuring IgG levels can better differentiate between primary and secondary dengue exposures, and suggests that including patient age and transmission intensity can improve screening accuracy.

Article Abstract

Owing to the finding that Dengvaxia (the only licensed dengue vaccine to date) increases the risk of severe illness among seronegative recipients, the World Health Organization has recommended screening individuals for their serostatus prior to vaccination. To decide whether and how to carry out screening, it is necessary to estimate the transmission intensity of dengue and to understand the performance of the screening method. In this study, we inferred the annual force of infection (FOI; a measurement of transmission intensity) of dengue virus in three locations in Vietnam: An Giang (FOI = 0.04 for the below 10 years age group and FOI = 0.20 for the above 10 years age group), Ho Chi Minh City (FOI = 0.12) and Quang Ngai (FOI = 0.05). In addition, we show that using a quantitative approach to immunoglobulin G (IgG) levels (measured by indirect enzyme-linked immunosorbent assays) can help to distinguish individuals with primary exposures (primary seropositive) from those with secondary exposures (secondary seropositive). We found that primary-seropositive individuals-the main targets of the vaccine-tend to have a lower IgG level, and, thus, they have a higher chance of being misclassified as seronegative than secondary-seropositive cases. However, screening performance can be improved by incorporating patient age and transmission intensity into the interpretation of IgG levels.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6685028PMC
http://dx.doi.org/10.1098/rsif.2019.0207DOI Listing

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