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  • Title: Antibody avidity following secondary dengue virus type 2 infection across a range of disease severity.
    Author: Lau L, Green AM, Balmaseda A, Harris E.
    Journal: J Clin Virol; 2015 Aug; 69():63-7. PubMed ID: 26209381.
    Abstract:
    BACKGROUND: The four dengue virus serotypes (DENV1-4) are responsible for the most prevalent mosquito-borne viral illness in humans. DENV causes a spectrum of disease from self-limiting dengue fever (DF) to severe, life-threatening dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). Antibodies from one infection can contribute to either protection or increased disease severity in a subsequent infection with a distinct DENV serotype. The effectiveness of the antibody response is modulated by both the affinity and avidity of the antibody/antigen interaction. OBJECTIVES: We investigated how antibody avidity developed over time following secondary DENV2 infection across different disease severities. STUDY DESIGN: We analyzed sera from 42 secondary DENV2-infected subjects (DF, n=15; DHF, n=16; DSS, n=11) from a pediatric hospital-based dengue study in Nicaragua. IgG avidity against DENV2 virions was measured in samples collected during acute and convalescent phases as well as 3, 6, and 18 months post-illness using a urea enzyme-linked immunosorbent assay. RESULTS: The data show a significant increase in avidity from acute to convalescent phase followed by a decrease from convalescent phase to 3 months post-symptom onset, then a plateau. Linear regression analysis comparing antibody avidity between disease severity groups over time indicate that individuals with more severe disease (DHF/DSS) experienced greater decay in antibody avidity over time compared to less severe disease (DF), and ROC curve analysis showed that at 18 months post-illness, lower avidity was associated with previously having experienced more severe disease. CONCLUSIONS: These data suggest that increased dengue disease severity is associated with lower antibody avidity at later time-points post-illness.
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