Incidence of Poliovirus Infection in Patients with Severe Combined Immunodeficiency (SCID)
Abstract
Background: Severe combined immunodeficiency (SCID) is a group of disorders with impairment in function of T, B and sometimes NK cells that could lead to high susceptibility to infectious diseases and premature death. Live-attenuated vaccines are contraindicated in SCID patients. However, in regions without screening programs for SCID, oral polio vaccine (OPV) could lead to vaccine-derived polioviruses (VDPVs) which are reverted to the neurovirulent virus types and could cause outbreaks of vaccine-associated paralytic poliovirus (VAPP) in communities with inadequate vaccine coverage.
Method: 20 SCID patients registered in Iranian national registry for Primary immunodeficiency (PID) disorders were tested for polio virus stool shedding. The demographic data, clinical presentation, polio test results, laboratory data and whole exome sequencing (WES) of the patients were available.
Results: Among the 20 SCID patients enrolled in the study, 6 patients tested positive for immunodeficiency-related VDPVs (iVDPV) shedding. Four patients (20%) had iVDPV type 2, one patient (5%) had iVDPV type 1 and one patient (5%) had iVDPV type 3.
Conclusion: Due to the high possibility of asymptomatic and long-term iVDPV shedding in SCID patients, the enhancement of screening of PID patients for poliovirus and iVDPV excretion is strongly needed
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17. Shaghaghi M, Shahmahmoodi S, Nili A, Abolhassani H, Madani S P, Nejati A, et al. Vaccine-Derived Poliovirus Infection among Patients with Primary Immunodeficiency and Effect of Patient Screening on Disease Outcomes, Iran. Emerg Infect Dis. 2019;25(11):2005-12.
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21. Lopez C, Biggar W D, Park B H,Good R A. Nonparalytic poliovirus infections in patients with severe combined immunodeficiency disease. J Pediatr. 1974;84(4):497-502.
22. Shaghaghi M, Shahmahmoodi S, Abolhassani H, Soleyman-Jahi S, Parvaneh L, Mahmoudi S, et al. Vaccine-derived polioviruses and children with primary immunodeficiency, Iran, 1995–2014. Emerg Infect Dis. 2016;22(10):1712.
23. Aghamohammadi A, Abolhassani H, Kutukculer N, Wassilak S G, Pallansch M A, Kluglein S, et al. Patients with Primary Immunodeficiencies Are a Reservoir of Poliovirus and a Risk to Polio Eradication. Front Immunol. 2017;8(685):685.
24. Organization W H,Initiative G P E. Polio endgame strategy 2019-2023: eradication, integration, certification and containment. World Health Organization; 2019.
25. Schonberger L B, Sullivan-Bolyai J Z,Bryan J A. Poliomyelitis in the United States. Adv Neurol. 1978;19:217-27.
26. Shaghaghi M, Irannejad M, Abolhassani H, Shahmahmoodi S, Hamidieh A A, Soleyman-Jahi S, et al. Clearing Vaccine-Derived Poliovirus Infection Following Hematopoietic Stem Cell Transplantation: a Case Report and Review of Literature. J Clin Immunol. 2018;38(5):610-16.
27. McKinlay M A, Collett M S, Hincks J R, Oberste M S, Pallansch M A, Okayasu H, et al. Progress in the development of poliovirus antiviral agents and their essential role in reducing risks that threaten eradication. J Infect Dis. 2014;210(suppl_1):S447-S53.
2. Chinn I K,Shearer W T. Severe Combined Immunodeficiency Disorders. Immunol Allergy Clin North Am. 2015;35(4):671-94.
3. Kwan A, Abraham R S, Currier R, Brower A, Andruszewski K, Abbott J K, et al. Newborn screening for severe combined immunodeficiency in 11 screening programs in the United States. JAMA. 2014;312(7):729-38.
4. Abolhassani H, Kiaee F, Tavakol M, Chavoshzadeh Z, Mahdaviani S A, Momen T, et al. Fourth Update on the Iranian National Registry of Primary Immunodeficiencies: Integration of Molecular Diagnosis. J Clin Immunol. 2018;38(7):816-32.
5. Aghamohammadi A, Mohammadinejad P, Abolhassani H, Mirminachi B, Movahedi M, Gharagozlou M, et al. Primary immunodeficiency disorders in Iran: update and new insights from the third report of the national registry. J Clin Immunol. 2014;34(4):478-90.
6. Heiman S, Weil M, Shulman L M, Simon A J, Lev A, Somech R, et al. Co-appearance of OPV and BCG vaccine-derived complications in two infants with severe combined immunodeficiency. Immunol Res. 2018;66(3):437-43.
7. Shaghaghi M, Parvaneh N, Ostad-Rahimi P, Fathi S M, Shahmahmoodi S, Abolhassani H, et al. Combined immunodeficiency presenting with vaccine-associated paralytic poliomyelitis: a case report and narrative review of literature. Immunol Invest. 2014;43(3):292-8.
8. Patel N C, Hertel P M, Estes M K, de la Morena M, Petru A M, Noroski L M, et al. Vaccine-acquired rotavirus in infants with severe combined immunodeficiency. N Engl J Med. 2010;362(4):314-9.
9. Bakare N, Menschik D, Tiernan R, Hua W,Martin D. Severe combined immunodeficiency (SCID) and rotavirus vaccination: reports to the Vaccine Adverse Events Reporting System (VAERS). Vaccine. 2010;28(40):6609-12.
10. Bayer D K, Martinez C A, Sorte H S, Forbes L R, Demmler-Harrison G J, Hanson I C, et al. Vaccine-associated varicella and rubella infections in severe combined immunodeficiency with isolated CD4 lymphocytopenia and mutations in IL7R detected by tandem whole exome sequencing and chromosomal microarray. Clin Exp Immunol. 2014;178(3):459-69.
11. Sadeghi-Shabestari M,Rezaei N. Disseminated bacille Calmette-Guerin in Iranian children with severe combined immunodeficiency. Int J Infect Dis. 2009;13(6):e420-3.
12. Marciano B E, Huang C Y, Joshi G, Rezaei N, Carvalho B C, Allwood Z, et al. BCG vaccination in patients with severe combined immunodeficiency: complications, risks, and vaccination policies. J Allergy Clin Immunol. 2014;133(4):1134-41.
13. Ni L, Seward J F, Santibanez T A, Pallansch M A, Kew O M, Prevots D R, et al. Vaccine policy changes and epidemiology of poliomyelitis in the United States. Jama. 2004;292(14):1696-701.
14. Alleman M M, Jorba J, Greene S A, Diop O M, Iber J, Tallis G, et al. Update on vaccine-derived poliovirus outbreaks—worldwide, July 2019–February 2020. MMWR 2020;69(16):489.
15. Kew O M, Sutter R W, de Gourville E M, Dowdle W R,Pallansch M A. Vaccine-derived polioviruses and the endgame strategy for global polio eradication. Annu Rev Microbiol. 2005;59:587-635.
16. Sobh A,Bonilla F A. Vaccination in Primary Immunodeficiency Disorders. J Allergy Clin Immunol Pract. 2016;4(6):1066-75.
17. Shaghaghi M, Shahmahmoodi S, Nili A, Abolhassani H, Madani S P, Nejati A, et al. Vaccine-Derived Poliovirus Infection among Patients with Primary Immunodeficiency and Effect of Patient Screening on Disease Outcomes, Iran. Emerg Infect Dis. 2019;25(11):2005-12.
18. Shahbazi Z, Yazdani R, Shahkarami S, Shahbazi S, Hamid M, Sadeghi-Shabestari M, et al. Genetic mutations and immunological features of severe combined immunodeficiency patients in Iran. Immunol Lett. 2019;216:70-78.
19. Organization W H. Polio laboratory manual. World Health Organization; 2004.
20. Shaghaghi M, Soleyman-Jahi S, Abolhassani H, Yazdani R, Azizi G, Rezaei N, et al. New insights into physiopathology of immunodeficiency-associated vaccine-derived poliovirus infection; systematic review of over 5 decades of data. Vaccine. 2018;36(13):1711-19.
21. Lopez C, Biggar W D, Park B H,Good R A. Nonparalytic poliovirus infections in patients with severe combined immunodeficiency disease. J Pediatr. 1974;84(4):497-502.
22. Shaghaghi M, Shahmahmoodi S, Abolhassani H, Soleyman-Jahi S, Parvaneh L, Mahmoudi S, et al. Vaccine-derived polioviruses and children with primary immunodeficiency, Iran, 1995–2014. Emerg Infect Dis. 2016;22(10):1712.
23. Aghamohammadi A, Abolhassani H, Kutukculer N, Wassilak S G, Pallansch M A, Kluglein S, et al. Patients with Primary Immunodeficiencies Are a Reservoir of Poliovirus and a Risk to Polio Eradication. Front Immunol. 2017;8(685):685.
24. Organization W H,Initiative G P E. Polio endgame strategy 2019-2023: eradication, integration, certification and containment. World Health Organization; 2019.
25. Schonberger L B, Sullivan-Bolyai J Z,Bryan J A. Poliomyelitis in the United States. Adv Neurol. 1978;19:217-27.
26. Shaghaghi M, Irannejad M, Abolhassani H, Shahmahmoodi S, Hamidieh A A, Soleyman-Jahi S, et al. Clearing Vaccine-Derived Poliovirus Infection Following Hematopoietic Stem Cell Transplantation: a Case Report and Review of Literature. J Clin Immunol. 2018;38(5):610-16.
27. McKinlay M A, Collett M S, Hincks J R, Oberste M S, Pallansch M A, Okayasu H, et al. Progress in the development of poliovirus antiviral agents and their essential role in reducing risks that threaten eradication. J Infect Dis. 2014;210(suppl_1):S447-S53.
| Files | ||
| Issue | Vol 4, No 2 (2021) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/igj.v4i2.9985 | |
| Keywords | ||
| Polio SCID Primary Immunodeficiency Oral Polio Vaccine | ||
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How to Cite
1.
Fayaz F, Sharafian S, Tavakol M. Incidence of Poliovirus Infection in Patients with Severe Combined Immunodeficiency (SCID). Immunol Genet J. 2021;4(2):95-100.
