Prolonged replication of a type 1 vaccine-derived poliovirus in an immunodeficient patient
Open accessAbstract
VP1 sequences were determined for poliovirus type 1 isolates obtained over a 189-day period from a poliomyelitis patient with common variable immunodeficiency syndrome (a defect in antibody formation). The isolate from the first sample, taken 11 days after onset of paralysis, contained two poliovirus populations, differing from the Sabin 1 vaccine strain by ∼10%, differing from diverse type 1 wild polioviruses by 19 to 24%, and differing from each other by 5.5% of nucleotides. Specimens taken after day 11 appeared to contain only one major poliovirus population. Evolution of VP1 sequences at synonymous third-codon positions occurred at an overall rate of ∼3.4% per year over the 189-day period. Assuming this rate to be constant throughout the period of infection, the infection was calculated to have started ∼9.3 years earlier. This estimate is about the time (6.9 years earlier) the patient received his last oral poliovirus vaccine dose, approximately 2 years before the diagnosis of immunodeficiency. These findings may have important implications for the strategy to eliminate poliovirus immunization after global polio eradication.
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The persistence of these viruses in immunocompromised individuals may compromise polio eradication efforts.
“The persistence of these viruses in immunocompromised individuals may compromise polio eradication efforts.”
From The Fight against Poliovirus Is Not Over (2023) · cites this paper as [107]
Recent reports describe highly divergent VDPVs associated with chronic poliovirus infections or with polio outbreaks.
“Recent reports describing highly divergent VDPVs associated with chronic poliovirus infections (10, 69, 88, 90, 113, 123, 216, 223) or with polio outbreaks (84, 169, 177, 226) underscored the earlier concerns and challenged the critical assumption that OPV-derived viruses would not long persist in the community.”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
Most RNA viruses have highly mutable genomes potentially capable of rapid evolution, many orders of magnitude faster than the genomes of DNA viruses or cellular organisms, and polioviruses are among the most rapidly evolving of all RNA viruses.
“Most RNA viruses have highly mutable genomes that are potentially capable of rapid evolution, many of orders of magnitude faster than the genomes of DNA viruses or cellular organisms (41, 45), and polioviruses are among the most rapidly evolving of all RNA viruses (60, 88, 108, 117, 185, 226).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
Nucleotide substitutions (>80% of which in the coding region are to synonymous codons) accumulate at an overall rate of ~1% per year at all sites, and at ~3% per year at synonymous sites.
“Nucleotide substitutions ( > 80% of which in the coding region are to synonymous codons) accumulate at an overall rate of ∼ 1% per year at all sites, and at ∼ 3% per year at synonymous sites (10, 60, 85, 88, 108, 117).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
They also appear to be largely independent of immune selection, as evolution rates are similar during prolonged replication in immunodeficient patients and during widespread circulation.
“They also appear to be largely independent of immune selection, as evolution rates are similar during prolonged replication in immunodeficient patients (10, 88, 117, 223) and during widespread circulation (60, 84, 85, 108).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
Other CVID patients developed paralysis several years after receipt of the implicated OPV dose (typically the last dose).
“Other CVID patients developed paralysis several years after receipt of the implicated OPV dose (typically the last dose) (10, 88, 223).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
Symptoms of immunodeficiency typically become evident later in life, usually in the second and third decades, even though prolonged poliovirus infections may have begun years before the diagnosis of CVID.
“Symptoms of immunodeficiency typically become evident later in life, usually in the second and third decades, even though prolonged poliovirus infections may have begun years before the diagnosis of CVID (10, 88, 223).”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
The neutralizing antigenic sites of iVDPV isolates are frequently highly divergent and variable, and immunodeficient prolonged excretors may be infected with more than one antigenic variant.
“the neutralizing antigenic sites of iVDPV isolates are frequently highly divergent and variable, and immunodeficient prolonged excretors may be infected with more than one antigenic variant”
From VACCINE-DERIVED POLIOVIRUSES AND THE ENDGAME STRATEGY FOR GLOBAL POLIO ERADICATION (2005) · cites this paper as [88]
Some iVDPV isolates are highly divergent (~90% VP1 sequence identity to the parental OPV strain), suggesting that chronic poliovirus infections had persisted for 10 years or more.
“Some iVDPV isolates are highly divergent (∼90% VP1 sequence identity to the parental OPV strain), suggesting that the chronic poliovirus infections had persisted for 10 years or more (25, 68).”
From Circulation of endemic type 2 vaccine-derived poliovirus in Egypt from 1983 to 1993 (2003) · cites this paper as [25]
In the rapidly evolving poliovirus genome, variable sites (about 33% of total VP1 nucleotides) saturate within about 30 years.
“In the rapidly evolving poliovirus genome (16, 25, 32, 35), variable sites (which represent ∼33% of total VP1 nucleotides, primarily at positions of codon degeneracy) saturate within ∼30 years.”
From Circulation of endemic type 2 vaccine-derived poliovirus in Egypt from 1983 to 1993 (2003) · cites this paper as [25]
Such sequence relationships are typical among isolates of locally circulating wild polioviruses and cVDPVs but not among OPV-like or iVDPV isolates from different patients, which generally follow independent pathways of divergence from the vaccine strain.
“Such sequence relationships are typical among isolates of locally circulating wild polioviruses (32, 55) and cVDPVs (22) but not among OPV-like or iVDPV isolates from different patients, which generally follow independent pathways of divergence from the vaccine strain (22, 25, 35; R. Park, unpublished results).”
From Circulation of endemic type 2 vaccine-derived poliovirus in Egypt from 1983 to 1993 (2003) · cites this paper as [25]
The VP1 evolution rate estimated from the slope of the regression line was (2.47 ± 0.69) × 10−2 substitutions per synonymous site per year, approximately 80% of the rate observed for circulating wild type 1 polioviruses.
“The VP1 evolution rate estimated from the slope of the regression line was (2.47 ± 0.69) × 10−2 substitutions per synonymous site per year, approximately 80% of the rate observed for circulating wild type 1 polioviruses (16, 25, 32).”
From Circulation of endemic type 2 vaccine-derived poliovirus in Egypt from 1983 to 1993 (2003) · cites this paper as [25]
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“These individuals may represent a potential source of virus reintroduction once the disease is eradicated [107,108].”
Background
- Authors
- Kew, O. M., Sutter, R. W., Nottay, B. K., McDonough, M. J., Prevots, D. R., Quick, L., & Pallansch, M. A.
- Affiliations
- National Center for Infectious Diseases (US)
- <!--label omitted: 2-->Divisions of Eradication of Vaccine-Preventable Diseases2 and
- Centers for Disease Control and Prevention (US)
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 1998-10
- Volume
- 36
- Issue
- 10
- Pages
- 2893-2899
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- PMC
- PMC105084
- OpenAlex
- W2159041114
- Cited by
- 213
- References
- 36
- Citations by year
- 2024: 4 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 9 · 2016: 4 · 2015: 3 · 2014: 16 · 2013: 6 · 2012: 14
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Microbiology (publishedVersion)
- PubMed Central (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Evolution and Genetic Dynamics
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Keywords
- poliovirus type 1, vaccine-derived poliovirus, common variable immunodeficiency, viral evolution, poliomyelitis, oral polio vaccine, polio eradication
- MeSH terms
- Adult, Amino Acid Sequence, Base Sequence, Capsid, Child, Feces, Follow-Up Studies, Humans, Immunologic Deficiency Syndromes, Male, Molecular Sequence Data, Phylogeny, Viral Plaque Assay, Poliomyelitis, Poliovirus Vaccine, Oral, RNA, Viral, Genetic Variation, Virus Replication, Polymerase Chain Reaction, Sequence Alignment, Sequence Homology, Amino Acid, Poliovirus, Evolution, Molecular, Capsid Proteins
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