埃博拉病毒病幸存者精液中埃博拉病毒RNA的持续存在——最终报告
Ebola RNA Persistence in Semen of Ebola Virus Disease Survivors - Final Report.
作者信息
Deen Gibrilla F, Broutet Nathalie, Xu Wenbo, Knust Barbara, Sesay Foday R, McDonald Suzanna L R, Ervin Elizabeth, Marrinan Jaclyn E, Gaillard Philippe, Habib Ndema, Liu Hongtu, Liu William, Thorson Anna E, Yamba Francis, Massaquoi Thomas A, James Faustin, Ariyarajah Archchun, Ross Christine, Bernstein Kyle, Coursier Antoine, Klena John, Carino Marylin, Wurie Alie H, Zhang Yong, Dumbuya Marion S, Abad Neetu, Idriss Baimba, Wi Teodora, Bennett Sarah D, Davies Tina, Ebrahim Faiqa K, Meites Elissa, Naidoo Dhamari, Smith Samuel J, Ongpin Patricia, Malik Tasneem, Banerjee Anshu, Erickson Bobbie R, Liu Yongjian, Liu Yang, Xu Ke, Brault Aaron, Durski Kara N, Winter Jörn, Sealy Tara, Nichol Stuart T, Lamunu Margaret, Bangura James, Landoulsi Sihem, Jambai Amara, Morgan Oliver, Wu Guizhen, Liang Mifang, Su Qiudong, Lan Yu, Hao Yanzhe, Formenty Pierre, Ströher Ute, Sahr Foday
机构信息
From the Sierra Leone Ministry of Health and Sanitation (G.F.D., F.Y., F.J., A.H.W., S.J.S., J.B., A.J.), the Sierra Leone Ministry of Defense (F.R.S., T.A.M., M.S.D., B.I., F.S.), and the Sierra Leone Ministry of Social Welfare, Gender, and Children's Affairs (T.D.) - all in Freetown, Sierra Leone; World Health Organization (N.B., S.L.R.M., J.E.M., P.G., N.H., A.E.T., A.A., A.C., M.C., T.W., F.K.E., D.N., A. Banerjee, K.N.D., M. Lamunu, S.L., P.F.) and the Joint United Nations Program on HIV/AIDS (P.O.), Geneva; Chinese Center for Disease Control and Prevention (W.X., H.L., W.L., Y.Z., Yongjian Liu, Yang Liu, K.X., G.W., M. Liang, Q.S., Y.H.) and Beijing Institute of Microbiology and Epidemiology (Y. Lan), Beijing; and the Centers for Disease Control and Prevention, Atlanta (B.K., E.E., C.R., K.B., J.K., N.A., S.D.B., E.M., T.M., B.R.E., A. Brault, J.W., T.S., S.T.N., O.M., U.S.).
出版信息
N Engl J Med. 2017 Oct 12;377(15):1428-1437. doi: 10.1056/NEJMoa1511410. Epub 2015 Oct 14.
BACKGROUND
Ebola virus has been detected in the semen of men after their recovery from Ebola virus disease (EVD). We report the presence of Ebola virus RNA in semen in a cohort of survivors of EVD in Sierra Leone.
METHODS
We enrolled a convenience sample of 220 adult male survivors of EVD in Sierra Leone, at various times after discharge from an Ebola treatment unit (ETU), in two phases (100 participants were in phase 1, and 120 in phase 2). Semen specimens obtained at baseline were tested by means of a quantitative reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay with the use of the target sequences of NP and VP40 (in phase 1) or NP and GP (in phase 2). This study did not evaluate directly the risk of sexual transmission of EVD.
RESULTS
Of 210 participants who provided an initial semen specimen for analysis, 57 (27%) had positive results on quantitative RT-PCR. Ebola virus RNA was detected in the semen of all 7 men with a specimen obtained within 3 months after ETU discharge, in 26 of 42 (62%) with a specimen obtained at 4 to 6 months, in 15 of 60 (25%) with a specimen obtained at 7 to 9 months, in 4 of 26 (15%) with a specimen obtained at 10 to 12 months, in 4 of 38 (11%) with a specimen obtained at 13 to 15 months, in 1 of 25 (4%) with a specimen obtained at 16 to 18 months, and in no men with a specimen obtained at 19 months or later. Among the 46 participants with a positive result in phase 1, the median baseline cycle-threshold values (higher values indicate lower RNA values) for the NP and VP40 targets were lower within 3 months after ETU discharge (32.4 and 31.3, respectively; in 7 men) than at 4 to 6 months (34.3 and 33.1; in 25), at 7 to 9 months (37.4 and 36.6; in 13), and at 10 to 12 months (37.7 and 36.9; in 1). In phase 2, a total of 11 participants had positive results for NP and GP targets (samples obtained at 4.1 to 15.7 months after ETU discharge); cycle-threshold values ranged from 32.7 to 38.0 for NP and from 31.1 to 37.7 for GP.
CONCLUSIONS
These data showed the long-term presence of Ebola virus RNA in semen and declining persistence with increasing time after ETU discharge. (Funded by the World Health Organization and others.).
背景
埃博拉病毒病（EVD）康复后的男性精液中已检测到埃博拉病毒。我们报告了在塞拉利昂的一组埃博拉病毒病幸存者的精液中存在埃博拉病毒RNA。
方法
我们选取了塞拉利昂220名成年男性埃博拉病毒病幸存者作为便利样本，在他们从埃博拉治疗单元（ETU）出院后的不同时间分两个阶段进行研究（第一阶段100名参与者，第二阶段120名）。通过定量逆转录聚合酶链反应（RT-PCR）检测基线时采集的精液标本，第一阶段使用NP和VP40的靶序列，第二阶段使用NP和GP的靶序列。本研究未直接评估埃博拉病毒病的性传播风险。
结果
在提供初始精液标本进行分析的210名参与者中，57人（27%）定量RT-PCR结果呈阳性。在ETU出院后3个月内采集标本的所有7名男性精液中均检测到埃博拉病毒RNA，4至6个月采集标本的42人中26人（62%）呈阳性，7至9个月采集标本的60人中15人（25%）呈阳性，10至12个月采集标本的26人中4人（15%）呈阳性，13至15个月采集标本的38人中4人（11%）呈阳性，16至18个月采集标本的25人中1人（4%）呈阳性，19个月及以后采集标本的男性均未检测到。在第一阶段结果呈阳性的46名参与者中，ETU出院后3个月内NP和VP40靶标的基线循环阈值中位数（值越高表明RNA值越低）（分别为32.4和31.3，7名男性）低于4至6个月（34.3和33.1；25名男性）、7至9个月（37.4和36.6；13名男性）以及10至12个月（37.7和36.9；1名男性）。在第二阶段，共有11名参与者NP和GP靶标结果呈阳性（ETU出院后4.1至15.7个月采集的样本）；NP的循环阈值范围为32.7至38.0，GP的循环阈值范围为31.1至37.7。
结论
这些数据表明精液中埃博拉病毒RNA长期存在，且随着ETU出院后时间的增加，持续存在的情况逐渐减少。（由世界卫生组织等资助。）
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