期刊
CLINICAL INFECTIOUS DISEASES
卷 63, 期 12, 页码 1584-1590出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciw589
关键词
dengue virus; chikungunya virus; Zika virus; coinfection; viremia
资金
- National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) [K08AI110528]
- NIH [R01AI099631, U54AI65359]
Background. Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses. Methods. Acute-phase serum samples from 346 patients with a suspected arboviral illness were tested using a multiplex realtime reverse-transcription polymerase chain reaction for ZIKV, CHIKV, and DENV. Viremia was quantitated for each detected virus, and clinical information from request forms submitted with each sample was recorded. Results. A total of 263 patients tested positive for 1 or more viruses: 192 patients tested positive for a single virus (monoinfections) and 71 patients tested positive for 2 or all 3 viruses (coinfections). Quantifiable viremia was lower in ZIKV infections compared with CHIKV or DENV (mean 4.70 vs 6.42 and 5.84 log(10) copies/mL serum, respectively; P<.001 for both comparisons), and for each virus, mean viremia was significantly lower in coinfections than in monoinfections. Compared with patients with CHIKV or DENV, ZIKV patients were more likely to have a rash (P<.001) and less likely to be febrile (P<.05) or require hospitalization (P<.001). Among all patients, hospitalized cases had higher viremia than those who did not require hospitalization (7.1 vs 4.1 log(10) copies/mL serum, respectively; P<.001). Conclusions. ZIKV, CHIKV, and DENV result in similar clinical presentations, and coinfections may be relatively common. Our findings illustrate the need for accurate, multiplex diagnostics for patient care and epidemiologic surveillance.
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