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Zika virus in semen and spermatozoa
Jean Michel Mansuy?,
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, Elsa Suberbielle?
, Sabine Chapuy-Regaud
, Catherine Mengelle
, Louis Bujan
, Bruno Marchou
, Pierre Delobel
, Daniel Gonzalez-Dunia
, C?cile E Malnou
, Jacques Izopet
, Guillaume Martin-Blondel
?Joint first authors
Published: October 2016
DOI: http://dx.doi.org/10.1016/S1473-3099(16)30336-X
Article Info
The current Zika virus epidemic is a major challenge for the medical and scientific communities for at least two reasons: the severe clinical situation associated with Zika virus infection (neurological complications and adverse fetal outcomes) and the unexpected sexual viral transmission from men to women.1 These recent findings have shifted the paradigm of arbovirus?host interactions, modifying standard epidemiology and clinical patterns.
High infectious Zika virus loads have been detected in semen,2 but data for viral persistence after symptomatic infections are scarce and even non-existent for asymptomatic ones, with the remaining key issue: how long does semen contain infectious Zika virus? As long as this question is unanswered, the adaptation of preventive measures such as the use of condoms and the abstinence of semen donation will be hampered.
Here, we report the longitudinal follow up of Zika virus RNA in the semen of a 32-year-old man returning from French Guyana. At admission, the patient had moderate fever, maculopapular rash, myalgia, and arthralgia and was diagnosed for Zika virus infection upon detection of viral RNA in plasma and urine 2 days after onset of symptoms. The molecular diagnosis for dengue and chikungunya viruses was negative (in-house RT-PCR). The patient was seronegative for HIV, had a normal immunological status, and recovered in few days. Semen (11 samples), blood (ten), and urine (five) were prospectively collected for 141 days after symptom onset. Zika virus RNA was detected on each semen sample and was still positive after 141 days, with viral load decreasing from 8?6 log copies per mL to 3?5 log copies per mL. It was detected until day 37 in both blood (2?5 log copies per mL) and urine (3?7 log copies per mL; figure).
Figure
Zika virus infects spermatozoa
On the left are the kinetics of Zika virus RNA detection in plasma, urine, and semen quantified by real-time RT-PCR (RealStar Zika Virus RT-PCR Kit 1.0; Altona Diagnostics GmbH, Hamburg, Germany). On the right is immunohistochemical detection of Zika virus (green; arrowhead) on brightfield microscopy in the head of spermatozoa obtained from the patient; Tom20 is pink; Zika virus is green; and Hoechst stain is blue.
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Such a prolonged RNA Zika virus excretion is quite different from other flaviviruses, which are rapidly cleared by the immune response and for which the detection of viral nucleic acids is typically limited to a short window after symptom onset. In addition to the present case, we investigated five other symptomatic men for the presence of Zika virus RNA in semen; RNA was still detected 69 days and 115 days after the symptom onset in two patients, but not detected at day 20 in the other three individuals (data not shown). These data suggest that the length of Zika virus excretion varies, probably depending on viral and host characteristics, but long-lasting excretion might be frequent among adults who experienced a symptomatic infection. Such long-lasting excretion of genomic material was recently described in semen from Ebola survivors.3
The viral persistence in semen is of major concern and could be related to a viral tropism for male sexual cells.
...
Zika virus in semen and spermatozoa
Jean Michel Mansuy?,
Press enter key to Email the author, Elsa Suberbielle?
, Sabine Chapuy-Regaud
, Catherine Mengelle
, Louis Bujan
, Bruno Marchou
, Pierre Delobel
, Daniel Gonzalez-Dunia
, C?cile E Malnou
, Jacques Izopet
, Guillaume Martin-Blondel
?Joint first authors
Published: October 2016
DOI: http://dx.doi.org/10.1016/S1473-3099(16)30336-X
Article InfoThe current Zika virus epidemic is a major challenge for the medical and scientific communities for at least two reasons: the severe clinical situation associated with Zika virus infection (neurological complications and adverse fetal outcomes) and the unexpected sexual viral transmission from men to women.1 These recent findings have shifted the paradigm of arbovirus?host interactions, modifying standard epidemiology and clinical patterns.
High infectious Zika virus loads have been detected in semen,2 but data for viral persistence after symptomatic infections are scarce and even non-existent for asymptomatic ones, with the remaining key issue: how long does semen contain infectious Zika virus? As long as this question is unanswered, the adaptation of preventive measures such as the use of condoms and the abstinence of semen donation will be hampered.
Here, we report the longitudinal follow up of Zika virus RNA in the semen of a 32-year-old man returning from French Guyana. At admission, the patient had moderate fever, maculopapular rash, myalgia, and arthralgia and was diagnosed for Zika virus infection upon detection of viral RNA in plasma and urine 2 days after onset of symptoms. The molecular diagnosis for dengue and chikungunya viruses was negative (in-house RT-PCR). The patient was seronegative for HIV, had a normal immunological status, and recovered in few days. Semen (11 samples), blood (ten), and urine (five) were prospectively collected for 141 days after symptom onset. Zika virus RNA was detected on each semen sample and was still positive after 141 days, with viral load decreasing from 8?6 log copies per mL to 3?5 log copies per mL. It was detected until day 37 in both blood (2?5 log copies per mL) and urine (3?7 log copies per mL; figure).
Zika virus infects spermatozoa
On the left are the kinetics of Zika virus RNA detection in plasma, urine, and semen quantified by real-time RT-PCR (RealStar Zika Virus RT-PCR Kit 1.0; Altona Diagnostics GmbH, Hamburg, Germany). On the right is immunohistochemical detection of Zika virus (green; arrowhead) on brightfield microscopy in the head of spermatozoa obtained from the patient; Tom20 is pink; Zika virus is green; and Hoechst stain is blue.
View Large Image | View Hi-Res Image | Download PowerPoint Slide
Such a prolonged RNA Zika virus excretion is quite different from other flaviviruses, which are rapidly cleared by the immune response and for which the detection of viral nucleic acids is typically limited to a short window after symptom onset. In addition to the present case, we investigated five other symptomatic men for the presence of Zika virus RNA in semen; RNA was still detected 69 days and 115 days after the symptom onset in two patients, but not detected at day 20 in the other three individuals (data not shown). These data suggest that the length of Zika virus excretion varies, probably depending on viral and host characteristics, but long-lasting excretion might be frequent among adults who experienced a symptomatic infection. Such long-lasting excretion of genomic material was recently described in semen from Ebola survivors.3
The viral persistence in semen is of major concern and could be related to a viral tropism for male sexual cells.
...
