Dynamics of Persistent Oral Cytomegalovirus Shedding During Primary Infection in Ugandan Infants

作者:Mayer Bryan T*; Matrajt Laura; Casper Corey; Krantz Elizabeth M; Corey Lawrence; Wald Anna; Gantt Soren; Schiffer Joshua T
来源:Journal of Infectious Diseases, 2016, 214(11): 1735-1743.
DOI:10.1093/infdis/jiw442

摘要

Cytomegalovirus (CMV) infection occurs frequently in young children, who, when infected, are then a major source of transmission. Oral CMV shedding by 14 infants with primary infection was comprehensively characterized using quantitative polymerase chain reaction weekly for >= 9 months. Three phases of oral shedding were identified: expansion, transition, and clearance. Viral expansion occurred over a median of 7 weeks, with a median doubling time of 3 days. During the transition phase, expansion slowed over a median of 6 weeks before peak viral load was reached. Clearance was slow (22-day median half-life), and shedding did not resolve during observation for any infant. Mathematical modeling demonstrated that prolonged oral CMV expansion is explained by a low within-host reproduction number (median, 1.63) and a delayed immune response that only decreases the infected cell half-life by 44%. Thus, the prolonged oral CMV shedding observed during primary infection can be explained by slow viral expansion and inefficient immunologic control.

  • 出版日期2016-12-1