Risk Factors for Ebola Virus Persistence in Semen of Survivors in Liberia.
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Dyal Jonathan, Kofman Aaron, Kollie Jomah Z, Fankhauser John, Orone Romeo, Soka Moses J, Glaybo Uriah, Kiawu Armah, Freeman Edna, Giah Giovanni, Tony Henry D, Faikai Mylene, Jawara Mary, Kamara Kuku, Kamara Samuel, Flowers Benjamin, Kromah Mohammed L, Desamu-Thorpe Rodel, Graziano James, Brown Shelley, Morales-Betoulle Maria E, Cannon Deborah L, Su Kaihong, Linderman Susanne L, Plucinski Mateusz, Rogier Eric, Bradbury Richard S, Secor W Evan, Bowden Katherine E, Phillips Christi, Carrington Mary N, Park Yeon-Hwa, Martin Maureen P, Aguinaga Maria Del Pilar, Mushi Robert, Haberling Dana L, Ervin Elizabeth D, Klena John D, Massaquoi Moses, Nyenswah Tolbert, Nichol Stuart T, Chiriboga David E, Williams Desmond E, Hinrichs Steven H, Ahmed Rafi, Vonhm Benjamin T, Rollin Pierre E, Purpura Lawrence J, Choi Mary J
Аннотация
METHODS: A cohort of 131 male EVD survivors in Liberia were enrolled in a case-case study. "Early clearers" were defined as those with 2 consecutive negative EBOV semen test results by real-time reverse-transcription polymerase chain reaction (rRT-PCR) ≥2 weeks apart within 1 year after discharge from the Ebola treatment unit or acute EVD. "Late clearers" had detectable EBOV RNA by rRT-PCR >1 year after discharge from the Ebola treatment unit or acute EVD. Retrospective histories of their EVD clinical course were collected by questionnaire, followed by complete physical examinations and blood work.
RESULTS: Compared with early clearers, late clearers were older (median, 42.5 years; P < .001) and experienced fewer severe clinical symptoms (median 2, P = .006). Late clearers had more lens opacifications (odds ratio, 3.9 [95% confidence interval, 1.1-13.3]; P = .03), after accounting for age, higher total serum immunoglobulin G3 (IgG3) titers (P = .005), and increased expression of the HLA-C*03:04 allele (0.14 [.02-.70]; P = .007).
CONCLUSIONS: Older age, decreased illness severity, elevated total serum IgG3 and HLA-C*03:04 allele expression may be risk factors for the persistence of EBOV in the semen of EVD survivors. EBOV persistence in semen may also be associated with its persistence in other immunologically protected sites, such as the eye.