Ebola viral load at diagnosis associates with patient outcome and outbreak evolution

Ebola virus (EBOV) causes periodic outbreaks of life-threatening EBOV disease in Africa. Historically, these outbreaks have been relatively small and geographically contained; however, the magnitude of the EBOV outbreak that began in 2014 in West Africa has been unprecedented. The aim of this study was to describe the viral kinetics of EBOV during this outbreak and identify factors that contribute to outbreak progression. From July to December 2014, one laboratory in Sierra Leone processed over 2,700 patient samples for EBOV detection by quantitative PCR (qPCR). Viremia was measured following patient admission. Age, sex, and approximate time of symptom onset were also recorded for each patient. The data was analyzed using various mathematical models to find trends of potential interest. The analysis revealed a significant difference (P = 2.7 × 10-77) between the initial viremia of survivors (4.02 log10 genome equivalents [GEQ]/ml) and nonsurvivors (6.18 log10 GEQ/ml). At the population level, patient viral loads were higher on average in July than in November, even when accounting for outcome and time since onset of symptoms. This decrease in viral loads temporally correlated with an increase in circulating EBOV-specific IgG antibodies among individuals who were suspected of being infected but shown to be negative for the virus by PCR. Our results indicate that initial viremia is associated with outcome of the individual and outbreak duration; therefore, care must be taken in planning clinical trials and interventions. Additional research in virus adaptation and the impacts of host factors on EBOV transmission and pathogenesis is needed..

Medienart:

Artikel

Erscheinungsjahr:

2015

Erschienen:

2015

Enthalten in:

Zur Gesamtaufnahme - volume:125

Enthalten in:

The journal of clinical investigation - 125(2015), 12, Seite 4421

Sprache:

Englisch

Beteiligte Personen:

de La Vega, Marc-Antoine [VerfasserIn]
Caleo, Grazia [Sonstige Person]
Audet, Jonathan [Sonstige Person]
Qiu, Xiangguo [Sonstige Person]
Kozak, Robert A [Sonstige Person]
Brooks, James I [Sonstige Person]
Kern, Steven [Sonstige Person]
Wolz, Anja [Sonstige Person]
Sprecher, Armand [Sonstige Person]
Greig, Jane [Sonstige Person]
Lokuge, Kamalini [Sonstige Person]
Kargbo, David K [Sonstige Person]
Kargbo, Brima [Sonstige Person]
Di Caro, Antonino [Sonstige Person]
Grolla, Allen [Sonstige Person]
Kobasa, Darwyn [Sonstige Person]
Strong, James E [Sonstige Person]
Ippolito, Giuseppe [Sonstige Person]
Van Herp, Michel [Sonstige Person]
Kobinger, Gary P [Sonstige Person]

Links:

Volltext
www.ncbi.nlm.nih.gov
search.proquest.com

BKL:

44.60

44.00

Themen:

Age
Datasets
Diagnosis
Ebola virus
Laboratories
Measurement
Methods
Pathogens
Patients
Population
Public health administration
Review boards
Viremia

doi:

10.1172/JCI83162

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC1962310167