Persistence of Detectable Immunoglobulin M Antibodies Up to 8 Years After Infection with West Nile Virus

Abstract

Abstract. In Houston, we have been monitoring the immune response to West Nile virus (WNV) infection in a large cohort of study participants since 2002. Using enzyme-linked immunosorbent assay techniques, serum from 163 participants was tested for the presence of anti-WNV immunoglobulin M (IgM) and IgG antibodies. We found that 42%, 34%, and 23% of study participants had either positive or equivocal results when tested for anti-WNV IgM antibodies approximately 1, 6, and 8 years post-infection, respectively. Conversely, almost one-half of study participants (46%) had undetectable anti-WNV IgG antibodies by 8 years post-infection. This study is the first study to calculate the slope of the rate of decay of antibodies over time as well as show persistence of detectable anti-WNV IgM antibodies up to 8 years post-infection. These findings warrant additional investigation, particularly the determination of whether persistence of IgM is related to persistent infection with WNV.

Neutralizing antibodies against West Nile virus identified directly from human B cells by single-cell analysis and next generation sequencing

“…2). These results are also consistent with previous reports of long-term persistence of WNV specific antibodies in serum 26,31,32 .…”

“…Both time points correspond to samples of the recently infected period following exposure to WNV. To identify post-convalescent subjects with high serum neutralizing antibody titers, we screened our cohort of more than 160 WNV subjects who we have monitored since 2002 26 . We initially selected individuals from asymptomatic and severe infection groups with a history of exposure less than 2 years after infection with WNV (total n=17, enrolled n=4).…”

Evaluation of Prolonged Fatigue Post–West Nile Virus Infection and Association of Fatigue with Elevated Antiviral and Proinflammatory Cytokines

“…Extended IgM antibody titers have been documented several years postinfection in humans (22,26,28), and persistent neurologic and renal infection has been documented in animal models (25,30,31). Previous findings in this cohort have found persistence of IgM antibodies in 42%, 34%, and 23% of WNV-positive study participants approximately 1, 6, and 8 years postinfection, respectively (19). However, we did not find any statistical correlations between IgM antibodies and fatigue in this study.…”

“…Subjectively, participants continued to report prolonged fatigue following infection, with 20% of study participants reporting fatigue up to 8 years later (20). Additionally, we recently reported the persistence of anti-WNV IgM antibodies in 23% of study participants 8 years following infection (19). We hypothesized that persistent activation of the pro-inflammatory innate immune response could be responsible for fatigue in our study population.…”

The Gulf Coast: A New American Underbelly of Tropical Diseases and Poverty

“…Possibly unique to WNV strains in Texas [13] is the observation that chronic persistent infection and prolonged immunoglobulin M (IgM) seropositivity is a common occurrence and is associated with several major clinical sequelae [14], including depression [15] and chronic kidney disease associated with viruria [16].…”