Antibodies to Zika virus, Campylobacter jejuni, gangliosides in Guillain Barre syndrome. A prospective single centre study from southern India

Abstract

The objective was to study the presence of antibodies against Zika virus, Camplyobacter jejuni and gangliosides in patients with Guillain Barre syndrome. Ninety consecutive patients (age more than 12 years) with GBS admitted to a tertiary care centre in southern India were included in this study. Data on the clinical manifestations, Nerve conduction studies and response to therapy were collected. The following tests were done in stored serum samples - Anti-Zika virus (IgM) antibodies, Anti-Campylobacter jejuni (IgG) antibodies and Anti-ganglioside antibodies (IgG). Those samples which were positive to Anti Zika antibodies were tested for conventional PCR for Zika virus, IgM antibodies against Dengue and Japanese encephalitis. Of the 90 patients, 3 died and 8 had persistent weakness. AIDP was the most common type of GBS (56.7%). Anti-ganglioside antibodies were present in 62.2% with GT1b being most common. Anti-C.jejuni antibodies were present in 46.6%. Anti-Zika antibodies (IgM) were present in 14 patients (15.5%). Four of these patients also had anti-Dengue antibody (IgM) positivity. This is one of the largest study on GBS from India and the first one to report on the presence of Zika antibodies form this geographical area. Our study had high prevalence of anti C.jejuni and anti ganglioside antibodies. Evidence of recent ZIKV infection as evidenced by anti IgM antibodies was present in 14 patients with 4 of them tested positive for anti-Dengue IgM antibody. Whether this represents cross reaction with Dengue or prior/co- infection with Dengue could not be addressed in this study.