Zika Virus Infection and Solid Organ Transplantation: A New Challenge

Abstract

Public health concerns exist surrounding the epidemic of the Zika virus (ZIKV) and the rapid growth of transplantation in developing countries, including endemic zones of active arbovirus transmission, as well as travel to such regions by potential organ donors and recipients. Few data exist regarding the clinical characteristics of ZIKV infection in immunocompromised hosts. Laboratory screening protocols for transplantation to differentiate ZIKV infections from other endemic viral diseases and for the detection of possible donor-derived infection have not been stated. The diagnosis of ZIKV infection remains a challenge, fueled by the lack of standardized commercially available diagnostic tests and validated reference diagnostic laboratories, as well as the limited duration of ZIKV viremia. In this small series, ZIKV infection in renal and liver recipients presented without rash, conjunctivitis, or neurological symptoms, and with abnormal graft function, thrombocytopenia, and bacterial superinfection. We report the first case series of ZIKV infection in solid organ recipients, with a description of clinical and laboratory features and therapeutic management.

Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients

“…Other authors have observed thrombocytopenia in solid organ transplant recipients with ZIKV infection. 13 CHKV viremia was not detected 30 days after diagnosis. ZIKV viremia persisted for at least 7 days in 1 oncohematological patient.…”

“…12 Another 4 cases of putative mosquito-transmitted ZIKV infection have recently been described in solid organ transplant recipients (2 renal and 2 liver), and no patient died or developed neurological symptoms. 13 …”

Síndrome congênita do vírus da zika: Manifestações oculares e resultados visuais

“…Outras formas de transmissão foram recentemente relatadas na literatura, tais como relações sexuais, transfusão de sangue, transplante de órgãos e, mais significativamente, a transmissão vertical. Além disso, os cientistas recentemente passaram a questionar se o contato com fluidos corporais infectados, como suor, lágrimas e saliva, poderia aumentar o risco de transmissão do vírus [19][20][21][22][23][24][25] . A transmissão sexual de ZIKV é uma questão importante, uma vez que o RNA viral foi detectado no sêmen 6 meses após o início dos sintomas, o que poderia potencialmente aumentar o risco de transmissão vertical aos fetos 20 .…”

Mitigating the risk of Zika virus contamination of raw materials and cell lines in the manufacture of biologicals

“…1). The predominant transmission route of ZIKV to humans occurs via the bite of an infected mosquito, although non-vector-borne routes of ZIKV transmission have been documented, including sexual transmission [24][25][26], blood transfusion [27,28], organ transplantation [29] and perinatal transplacental transmission [30]. Infectious ZIKV particles have been detected in saliva, blood, serum, semen and urine [25,28,[31][32][33] of infected humans.…”