Dengue and Chikungunya are two major arboviral infections transmitted worldwide by the mosquitoes, Aedes aegypti and Ae. albopictus. India suffers enormously with both Dengue and Chikungunya as they pose a great public health challenge. The present study aims to evaluate the prevalence of Dengue Virus (DENV), Chikungunya Virus (CHIKV) and DENV/CHIKV co-infection (by Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR)/Enzyme Linked Immunosorbent Assay (ELISA), their clinical features, DENV serotypes and CHIKV specific Immunoglobulin G (IgG) within a 7 years gap in the Delhi population. The study sample included clinically suspected febrile patients (?7 days) sera collected during 2017-2018 (n=87) and during 2008-2010 (n=623) from Delhi. Captured ELISA was performed for CHIKV IgG screening and nested PCR was done for DENV serotyping. The percentage prevalence for DENV was significantly higher than CHIKV with 41.38% (n=87) and 16.1% (n=87), respectively; interestingly, DENV/CHIKV co-infection was detected in 10.34% (n=9/87) cases during 2017-2018. Similarly, a high DENV prevalence was observed during 2008-2010 with the prevalence rate of 38.3% (69/180), 34.65% (35/101) and 47.07% (161/342), respectively. DENV 1 and DENV 3 were dominant serotype during 2008-2010 and 2017-2018 respectively. We have noticed a high prevalence (36.67%, 22/60) of the CHIKV IgG antibody in the 2017-2018 samples. Joint pain was more preferential to CHIKV mono-infection and DENV/CHIKV co-infection compared to DENV mono-infection. The present study highlights the need for active surveillance simultaneously for both DENV and CHIKV and to evaluate the role of CHIKV/DENV co-infections in disease severity in the endemic regions.
Chikungunyna virus is expanding globally and continue to cause major public health threat to Indian populations. Vaccine efforts are underway, and it is hoped that these will eventually progress to human evaluation. However, currently we have little understanding of the phenotypes and functions of the human T cells in chikungunya patients, a knowledge that is essential for improving vaccine design/testing and evaluation efforts. Here, we provide a detailed analysis of the CD8 T cell responses in chikungunya patients from India. We found that CD38+ HLADR+ CD8 T cell subset expanded dramatically in chikungunya febrile patients with frequencies averaging about 20% of the total CD8 T cells, and reaching as high as 50% of the CD8 T cells in some patients. The frequencies of these activated CD8 T cells were substantially low and barely above background levels in afebrile patients reporting to the clinic with persistent arthralgia/arthritis that was lasting for more than 30 days. These massively expanding CD8 T cells observed in the acute febrile patients were highly proliferating (KI67 ), robustly expressing markers indicative strong Th1 differentiation (T-bet), cytotoxic functions (Perforin) and inflammatory/synovial tissue homing characteristics (CX3CR1 and CXCR4). Interestingly, antigen-stimulation mediated IFN-g producing functions of these cells was highly compromized, reminiscent of the “cytokine stunned” phenotype. Taken together, these results suggest that these highly differentiated effector CD8 T cell that were massively expanding during acute chikungunya febrile infection might be involved in protection by homing to infected tissues and eliminating infected targets rather than causing inflammation.
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