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https://www.arca.fiocruz.br/handle/icict/55942
WHY DID ZIKV PERINATAL OUTCOMES DIFFER IN DISTINCT REGIONS OF BRAZIL? AN EXPLORATORY STUDY OF TWO COHORTS
Author
Damasceno, Luana
Terzian, Ana Carolina Bernardes
Fuller, Trevon
Estofolete, Cassia F
Andrade, Adriana
Kroon, Erna Geessien
Zin, Andrea A
Vasconcelos, Zilton
Pereira Junior, Jose P
Castilho, Márcia C
Piaulino, Isa Cristina R
Vasilakis, Nikos
Moreira, Maria E
Nielsen-Saines, Karin
Espinosa, Flor E Martinez
Nogueira, Maurício L
Brasil, Patricia
Terzian, Ana Carolina Bernardes
Fuller, Trevon
Estofolete, Cassia F
Andrade, Adriana
Kroon, Erna Geessien
Zin, Andrea A
Vasconcelos, Zilton
Pereira Junior, Jose P
Castilho, Márcia C
Piaulino, Isa Cristina R
Vasilakis, Nikos
Moreira, Maria E
Nielsen-Saines, Karin
Espinosa, Flor E Martinez
Nogueira, Maurício L
Brasil, Patricia
Affilliation
Acute Febrile Illnesses Laboratory. National Institute of Infectious Diseases. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.
Acute Febrile Illnesses Laboratory. National Institute of Infectious Diseases. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Laboratory of Virology. School of Medicine. São José do Rio Preto, SP, Brazil.
Institute of Biological Sciences. Federal University of Minas Gerais .Belo Horizonte, MG, Brazil.
Institute of Biological Sciences. Federal University of Minas Gerais .Belo Horizonte, MG, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Department of Virology. Dr. Heitor Vieira Dourado Tropical Medicine Foundation. Manaus, AM, Brazil.
Postgraduate Program in Tropical Medicine. Amazonas State University. Manaus, AM, Brazil.
Department of Pathology. University of Texas Medical Branch. Galveston, TX, USA.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Department of Pediatrics. David Geffen School of Medicine. University of California. Los Angeles, CA, USA.
Laboratory of Territory, Environment, Health, and Sustainability. Leônidas & Maria Deane Institute. Oswaldo Cruz Foundation., Manaus, AM, Brazil/Department of Malaria. Dr. Heitor Vieira Dourado Tropical Medicine Foundation. Manaus, AM, Brazil.
Laboratory of Virology. School of Medicine. São José do Rio Preto, SP, Brazil.
Acute Febrile Illnesses Laboratory. National Institute of Infectious Diseases. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
René Rachou Institute. Oswaldo Cruz Foundation. Belo Horizonte, MG, Brazil.
Acute Febrile Illnesses Laboratory. National Institute of Infectious Diseases. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Laboratory of Virology. School of Medicine. São José do Rio Preto, SP, Brazil.
Institute of Biological Sciences. Federal University of Minas Gerais .Belo Horizonte, MG, Brazil.
Institute of Biological Sciences. Federal University of Minas Gerais .Belo Horizonte, MG, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Department of Virology. Dr. Heitor Vieira Dourado Tropical Medicine Foundation. Manaus, AM, Brazil.
Postgraduate Program in Tropical Medicine. Amazonas State University. Manaus, AM, Brazil.
Department of Pathology. University of Texas Medical Branch. Galveston, TX, USA.
Fernandes Figueira Institute. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Department of Pediatrics. David Geffen School of Medicine. University of California. Los Angeles, CA, USA.
Laboratory of Territory, Environment, Health, and Sustainability. Leônidas & Maria Deane Institute. Oswaldo Cruz Foundation., Manaus, AM, Brazil/Department of Malaria. Dr. Heitor Vieira Dourado Tropical Medicine Foundation. Manaus, AM, Brazil.
Laboratory of Virology. School of Medicine. São José do Rio Preto, SP, Brazil.
Acute Febrile Illnesses Laboratory. National Institute of Infectious Diseases. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.
Abstract
The Zika virus (ZIKV) epidemic in Brazil occurred in regions where dengue viruses (DENV) are historically endemic. We investigated the differences in adverse pregnancy/infant outcomes in two cohorts comprising 114 pregnant women with PCR-confirmed ZIKV infection in Rio de Janeiro, Southeastern Brazil (n = 50) and Manaus, in the north region of the country (n = 64). Prior exposure to DENV was evaluated through plaque reduction neutralizing antibody assays (PRNT 80) and DENV IgG serologies. Potential associations between pregnancy outcomes and Zika attack rates in the two cities were explored. Overall, 31 women (27%) had adverse pregnancy/infant outcomes, 27 in Rio (54%) and 4 in Manaus (6%), p < 0.001. This included 4 pregnancy losses (13%) and 27 infants with abnormalities at birth (24%). A total of 93 women (82%) had evidence of prior DENV exposure, 45 in Rio (90%) and 48 in Manaus (75%). Zika attack rates differed; the rate in Rio was 10.28 cases/10,000 and in Manaus, 0.6 cases/10,000, p < 0.001. Only Zika attack rates (Odds Ratio: 17.6, 95% Confidence Interval 5.6-55.9, p < 0.001) and infection in the first trimester of pregnancy (OR: 4.26, 95% CI 1.4-12.9, p = 0.011) were associated with adverse pregnancy and infant outcomes. Pre-existing immunity to DENV was not associated with outcomes (normal or abnormal) in patients with ZIKV infection during pregnancy.
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