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DRC - Follow-up of patients cured of Ebola virus disease

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  • DRC - Follow-up of patients cured of Ebola virus disease

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    Follow-up of patients cured of Ebola virus disease


    Certain treatments to combat the Ebola virus, notably those based on monoclonal antibodies 1 , have increased the survival rate of patients with the disease and are now recommended. Researchers from IRD, Inserm, ANRS | Emerging Infectious Diseases and the INRB, evaluated, for the first time, the antibody response in survivors of the tenth Ebola epidemic in the Democratic Republic of Congo (DRC) who received specific drugs against the virus. This study on the “Ebola Victors” cohort was initiated as part of the French response to the Ebola epidemic and was part of the Franco-Congolese roadmap signed by the Congolese and French presidents. Its results, published on November 30 in The Lancet infectious Diseases , show that monoclonal antibodies could have a negative impact on the production of anti-Ebola antibodies over time and thus potentially increase the risk of reinfection or reactivation.

    Ebola virus disease is a serious infection with a fatality rate of between 30 and 90% if left untreated. Between 2018 and 2020, in the provinces of North Kivu, South Kivu and Ituri (DRC), the tenth Ebola epidemic was the longest and deadliest ever recorded so far in the country , and the second largest in the world, after that of 2013-2016 in West Africa.

    The experience gained during previous epidemics has enabled the adoption of preventive measures and the implementation of new strategies to combat the virus.
    Thus, certain specific drugs against Ebola, in particular monoclonal antibodies, have made it possible to improve patient care and survival.
    In this study, to better understand the long-term effects of these treatments, researchers assessed the humoral immune response 2 in survivors treated with anti-Ebola drugs during the tenth Ebola outbreak in the DRC.

    Participants in the observational study, “Ebola Victors,” were recruited on the day they were discharged from the Ebola Treatment Center (ETC) and followed for up to 12 months. Of the 787 survivors included in the study, the researchers studied the antibody response for 358 of them: upon discharge, almost a quarter were seronegative for at least two virus antigens. People who received specific treatments against Ebola, in particular monoclonal antibodies (Ansuvimab), experienced, over time, a rapid decline in their levels of antibodies to the virus. These results raise many questions, in particular concerning the impact of these antibodies on viral persistence in privileged immune sites with a risk of relapse or persistent clinical manifestations (sequalae), and also on the risk of reinfection in these patients.

    This study highlights the need for continued research on the human reservoir of the Ebola virus in order to better understand the factors of persistence and resurgence of the virus and thus develop drugs capable of eradicating it.

    From a public health perspective, it is important to continue monitoring people declared recovered from Ebola virus infection and to discuss the advisability of vaccinating them to help prevent any resurgence or reinfection. Finally, this study illustrates the importance of interventions during epidemic periods, combining three essential actions: care, research and the ability of teams to mobilize.

    1 antibody manufactured specifically to treat a disease
    ² is characterized by the excretion in the serum of antibodies specific for a given antigen​

    Certains traitements pour lutter contre le virus Ebola, notamment ceux à base d'anticorps monoclonaux 1, ont augmenté le taux de survie des patients atteints de la maladie et sont maintenant recommandés. Des chercheurs de l’IRD, l’Inserm, l’ANRS | Maladies infectieuses émergentes et l’INRB, ont évalué, pour la première fois, la réponse des anticorps chez les survivants de la dixième épidémie d'Ebola en République démocratique du Congo (RDC) ayant reçu des médicaments spécifiques contre le virus.



    Effect of anti-Ebola virus monoclonal antibodies on endogenous antibody production in survivors of Ebola virus disease in the Democratic Republic of the Congo: an observational cohort studyPublished:November 30, 2023DOI:



    The use of specific anti-Ebola virus therapy, especially monoclonal antibodies, has improved survival in patients with Ebola virus disease. We aimed to assess the effect of monoclonal antibodies on anti-Ebola virus antibody responses in survivors of the 2018–20 Ebola outbreak in the Democratic Republic of the Congo.

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