Maternal antibody and viral factors in the pathogenesis of dengue virus in infants

Cameron P. Simmons, Tran Nguyen Bich Chau, Thi Thuy Tran, Minh Tuan Nguyen, Minh Hoang Dang, Thanh Thien Nguyen, Bich Lien Le, Thien Quy Nguyen, Trong Hieu Nguyen, Tinh Hien Tran, Catriona McElnea, Paul Young, Steve Whitehead, Thanh Hung Nguyen, Jeremy Farrar

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120 Citations (Scopus)


The pathogenesis of dengue in infants is poorly understood. We postulated that dengue severity in infants would be positively associated with markers of viral burden and that maternally derived, neutralizing antidengue antibody would have decayed before the age at which infants with dengue presented to the hospital. In 75 Vietnamese infants with primary dengue, we found significant heterogeneity in viremia and NS1 antigenemia at hospital presentation, and these factors were independent of disease grade or continuous measures of disease severity. Neutralizing antibody titers, predicted in each infant at the time of their illness, suggested that the majority of infants (65%) experienced dengue hemorrhagic fever when the maternally derived neutralizing antibody titer had declined to <1:20. Collectively, these data have important implications for dengue vaccine research because they suggest that viral burden may not solely explain severe dengue in infants and that neutralizing antibody is a reasonable but not absolute marker of protective immunity in infants.

Original languageEnglish
Pages (from-to)416-424
Number of pages9
JournalJournal of Infectious Diseases
Issue number3
Publication statusPublished - 1 Aug 2007

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