Impact of previous exposure to Zika virus on acute dengue infection: Epidemiological, clinical, immunological and virological aspects.

Abstract

Arbovirosis are relevant diseases with collective and individual impact worldwide. In the last years, it has been highlighted the dengue and Zika spread in intertropical areas. Dengue is a viral infection considered the most important arbovirosis in the world in terms of morbidity and mortality. Historically, severe cases associated with hospitalizations and deaths are observed after a dengue infection by heterologous serotype, resulting in a cytocine storm and capillary permeability increase. Recent studies, following the Zika emergence as arbovirus of public health impact, has been hypothetized that prior immunity to flavivirus infection might promote such physiopathogenic mechanism with exacerbated immune response and, consequently, more severe outcomes in dengue. On the other hand, some studies suggested protective effect of previous presence of anti-Zika antibody to secundary dengue infection. Considering the current ecpidemiologic contex of arbovirosis in the country and, specially, in São José do Rio Preto, São Paulo, this study aims analyzing the impacto of prior antibodies to Zika infection in outcomes of dengue infection by serotype 2 during city epidemics in 2019 and 2022, in addition to performing a controlled assay with mice simulating the previous ZIKV infection followed by DENV infection to elucidate this correlation.