International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Long-term kinetics of IgG, IgM, and neutralizing antibodies in patients with severe fever with thrombocytopenia syndrome: A 5-year follow-up study.
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Bang Mi-Seon, Kim Choon-Mee, Kim Dong-Min, Seo Jun-Won, Kim Da Young, Yun Na-Ra, Kim Jieun, Jung Sook In, Kim Uh Jin, Kim Seong Eun, Kim Hyunah, Kim Eu Suk, Hur Jian, Bae Jacob Sangwoon, Kim Young Keun, Jeong Hye Won, Heo Jung Yeon, Lee Hyungdon, Park Sun Hee, Kwak Yee Gyung, Lim Seungjin
Аннотация
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a life-threatening tick-borne disease endemic to East Asia. Despite its high fatality rate and increasing incidence, the long-term kinetics of humoral immune responses in patients with SFTS remain poorly understood.
METHODS: We analyzed serum from 109 patients hospitalized with SFTS between 2015 and 2023. Antibody responses were assessed using indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and plaque reduction neutralization test (PRNT). Antibody kinetics were described by outcome, but time-to-seroconversion was not compared because follow-up differed before death.
RESULTS: The SFTSV viral load peaked within 1-9 days after symptom onset, before declining. SFTSV-specific IgG antibodies were detected by IFA from days 5-9 and by ELISA from days 10-14, peaking on days 20-24. IgM responses appeared later, peaking on days 20-24 (IFA) and 25-29 (ELISA). Neutralizing antibodies (PRNT50 ≥ 1:10) emerged from day 10 and peaked on days 20-24. SFTSV-specific IgG and neutralizing antibodies remained detectable for up to 5 years, with all patients evaluated at the 5-year follow-up remaining seropositive (3/3). Seroconversion of IgG and neutralizing antibodies occurred only in survivors and was absent in fatal cases. IgM responses were completely undetectable in fatal patients.
CONCLUSION: SFTSV-specific binding and neutralizing antibodies developed strongly in survivors and persisted for up to 5 years. Seroconversion was not detected in fatal cases, although this may reflect limited follow-up. These findings indicate a link between early humoral responses and clinical outcomes, but do not establish protective immunity.
METHODS: We analyzed serum from 109 patients hospitalized with SFTS between 2015 and 2023. Antibody responses were assessed using indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and plaque reduction neutralization test (PRNT). Antibody kinetics were described by outcome, but time-to-seroconversion was not compared because follow-up differed before death.
RESULTS: The SFTSV viral load peaked within 1-9 days after symptom onset, before declining. SFTSV-specific IgG antibodies were detected by IFA from days 5-9 and by ELISA from days 10-14, peaking on days 20-24. IgM responses appeared later, peaking on days 20-24 (IFA) and 25-29 (ELISA). Neutralizing antibodies (PRNT50 ≥ 1:10) emerged from day 10 and peaked on days 20-24. SFTSV-specific IgG and neutralizing antibodies remained detectable for up to 5 years, with all patients evaluated at the 5-year follow-up remaining seropositive (3/3). Seroconversion of IgG and neutralizing antibodies occurred only in survivors and was absent in fatal cases. IgM responses were completely undetectable in fatal patients.
CONCLUSION: SFTSV-specific binding and neutralizing antibodies developed strongly in survivors and persisted for up to 5 years. Seroconversion was not detected in fatal cases, although this may reflect limited follow-up. These findings indicate a link between early humoral responses and clinical outcomes, but do not establish protective immunity.