Evidence of Zika Virus Reinfection by Genome Diversity and Antibody Response Analysis, Brazil
Márcia da Costa Castilho, Ana María Bispo de Filippis, Laís Ceschini Machado, Thaise Yasmine Vasconcelos de Lima Calvanti, Morganna Costa Lima, Vagner Fonseca, Marta Giovanetti, Cássia Docena, Armando Menezes‐Neto, Camila Bôtto-Menezes, Edna Kara, Rafael De La Barrera, Kayvon Modjarrad, Silvana Pereira Giozza, Gérson Fernando Mendes Pereira, Luiz Carlos Junior Alcantara, Nathalie Broutet, Guilherme Amaral Calvet, Gabriel Luz Wallau, Rafael Freitas de Oliveira França
Abstract
We generated 238 Zika virus (ZIKV) genomes from 135 persons in Brazil who had samples collected over 1 year to evaluate virus persistence. Phylogenetic inference clustered the genomes together with previously reported ZIKV strains from northern Brazil, showing that ZIKV has been remained relatively stable over time. Temporal phylogenetic analysis revealed limited within-host diversity among most ZIKV-persistent infected associated samples. However, we detected unusual virus temporal diversity from >5 persons, uncovering the existence of divergent genomes within the same patient. All those patients showed an increase in neutralizing antibody levels, followed by a decline at the convalescent phase of ZIKV infection. Of interest, in 3 of those patients, titers of neutralizing antibodies increased again after 6 months of ZIKV infection, concomitantly with real-time reverse transcription PCR re-positivity, supporting ZIKV reinfection events. Altogether, our findings provide evidence for the existence of ZIKV reinfection events.