AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 69(6 suppl), 2003, pp. 32-38
Copyright © 2003 by The American Society of Tropical Medicine and Hygiene

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*Dengue

ATYPICAL ANTIBODY RESPONSES IN DENGUE VACCINE RECIPIENTS

N. KANESA-THASAN, W. SUN, G. V. LUDWIG, C. ROSSI, J. R. PUTNAK, J. A. MANGIAFICO, B. L. INNIS, AND R. EDELMAN
Walter Reed Army Institute of Research, Washington, District of Columbia; United States Army Institute for Infectious Diseases, Fort Detrick, Frederick, Maryland; Department of Medicine and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland

Eight of 69 (12%) healthy adult volunteers vaccinated with monovalent live-attenuated dengue virus (DENV) vaccine candidates had atypical antibody responses, with depressed IgM:IgG antibody ratios and induction of high-titer hemagglutination-inhibiting and neutralizing (NT) antibodies to all four DENV serotypes. These features suggested flavivirus exposure prior to DENV vaccination, yet no volunteer had a history of previous flavivirus infection, flavivirus vaccination, or antibody to flaviviruses evident before DENV vaccination. Moreover, production of antibody to DENV by atypical responders (AR) was not accelerated compared with antibody responses in the 61 flavivirus-naive responders (NR). Further evaluation revealed no differences in sex, age, race, DENV vaccine candidate received, or clinical signs and symptoms following vaccination between AR and NR. However, viremia was delayed at the onset in AR compared with NR. A comparative panel of all AR and five randomly selected NR found flavivirus cross-reactive antibody after vaccination only in AR. Unexpectedly, six of eight AR had NT antibodies to yellow fever virus (YFV) > 1:10 before vaccination while NR had none (P = 0.04). The AR also universally demonstrated YFV NT antibody titers >= 1:160 after DENV vaccination, whereas four of five NR failed to seroconvert (P = 0.02). Yellow fever virus priming broadens the antibody response to monovalent DENV vaccination. The effect of flavivirus priming on the clinical and immunologic response to tetravalent DENV vaccine remains to be determined.


Authors’ addresses: N. Kanesa-thasan, G. V. Ludwig, C. Rossi, and J. A. Mangiafico, Medical Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, Frederick, MD 21702, Telephone: 301-619-4595, Fax: 301-619-2511, E-mail: niranjan.kanesa-thasan{at}det.amedd.army.mil. W. Sun, and J. R. Putnak, Department of Virus Diseases, Division of Communicable Diseases and Immunology, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910. B.L. Innis,1 B. L. Innis, GlaxoSmithKline, 1250 South Collegeville Road, Mail Code UP4330, Collegeville, PA 19426-0989. R. Edelman, Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, Baltimore, MD 21201, Telephone: 410-706-5328, Fax: 410-706-6205.




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ERRATA
Am J Trop Med Hyg, March 1, 2004; 70(3): 336 - 337.
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