Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
David Geffen UCLA School of Medicine, Los Angeles, CA, 90095, USA.
Nat Commun. 2020 Jul 14;11(1):3510. doi: 10.1038/s41467-020-17331-0.
We report Zika virus (ZIKV) vertical transmission in 130 infants born to PCR+ mothers at the time of the Rio de Janeiro epidemic of 2015-2016. Serum and urine collected from birth through the first year of life were tested by quantitative reverse transcriptase polymerase chain reaction (PCR) and/or IgM Zika MAC-ELISA. Four hundred and seven specimens are evaluated; 161 sera tested by PCR and IgM assays, 85 urines by PCR. Sixty-five percent of children (N = 84) are positive in at least one assay. Of 94 children tested within 3 months of age, 70% are positive. Positivity declines to 33% after 3 months. Five children are PCR+ beyond 200 days of life. Concordance between IgM and PCR results is 52%, sensitivity 65%, specificity 40% (positive PCR results as gold standard). IgM and serum PCR are 61% concordant; serum and urine PCR 55%. Most children (65%) are clinically normal. Equal numbers of children with abnormal findings (29 of 45, 64%) and normal findings (55 of 85, 65%) have positive results, p = 0.98. Earlier maternal trimester of infection is associated with positive results (p = 0.04) but not clinical disease (p = 0.98). ZIKV vertical transmission is frequent but laboratory confirmed infection is not necessarily associated with infant abnormalities.
我们报告了在 2015-2016 年里约热内卢流行期间，130 名 PCR+母亲所生婴儿的寨卡病毒（ZIKV）垂直传播。从出生到一岁收集的血清和尿液通过定量逆转录聚合酶链反应（PCR）和/或 IgM 寨卡 MAC-ELISA 进行检测。评估了 407 份标本；161 份血清通过 PCR 和 IgM 检测，85 份尿液通过 PCR 检测。65%的儿童（N=84）至少有一种检测呈阳性。在 3 个月龄内接受检测的 94 名儿童中，有 70%呈阳性。3 个月后，阳性率下降至 33%。5 名儿童在 200 天以上的生命期内 PCR+。IgM 和 PCR 结果的一致性为 52%，灵敏度为 65%，特异性为 40%（以阳性 PCR 结果为金标准）。IgM 和血清 PCR 的一致性为 61%；血清和尿液 PCR 的一致性为 55%。大多数儿童（65%）临床表现正常。有异常发现的儿童（29/45，64%）和正常发现的儿童（55/85，65%）数量相等，p=0.98。母亲感染的更早孕期与阳性结果相关（p=0.04），但与婴儿异常无关（p=0.98）。ZIKV 垂直传播很常见，但实验室确诊感染不一定与婴儿异常有关。
