Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne disease in East Asia that is causing high mortality. The Gn glycoprotein of the SFTS virus (SFTSV) has been considered to be an essential target for virus neutralization. However, data on anti-Gn glycoprotein antibody kinetics are limited. Therefore, we investigated the kinetics of Gn-specific antibodies compared to those of nucleocapsid protein (NP)-specific antibodies. A multicenter prospective study was performed in South Korea from January 2018 to September 2021. Adult patients with SFTS were enrolled. Anti-Gn-specific IgM and IgG were measured using an enzyme-linked immunosorbent assay. A total of 111 samples from 34 patients with confirmed SFTS were analyzed. Anti-Gn-specific IgM was detected at days 5–9 and peaked at day 15–19 from symptom onset, whereas the anti-NP-specific IgM titers peaked at days 5–9. Median seroconversion times of both anti-Gn- and NP-specific IgG were 7.0 days. High anti-Gn-specific IgG titers were maintained until 35–39 months after symptom onset. Only one patient lost their anti-Gn-specific antibodies at 41 days after symptom onset. Our data suggested that the anti-Gn-specific IgM titer peaked later than anti-NP-specific IgM, and that anti-Gn-specific IgG remain for at least 3 years from symptom onset.
Highlights
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne disease with mortality rates reportedly ranging from 12.3 to 32.6% [1,2,3]
We evaluated the kinetics of anti-Gn-specific antibodies in SFTS patients throughout a three-year follow-up period
Anti-Gn-specific IgM antibodies were detectable later than nucleocapsid protein (NP)-specific IgM, and the titer of anti-Gn-specific IgM peaked at days 15–19 after symptom onset
Summary
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne disease with mortality rates reportedly ranging from 12.3 to 32.6% [1,2,3]. SFTS is characterized by high fever, myalgia, thrombocytopenia, and leukocytopenia, and can result in multiple organ failure in severe cases [2,3]. Previous studies have suggested that a failure of the virus-specific IgG response is related with poor outcomes of SFTS patients, showing the absence of NP-specific IgM and IgG antibodies and Gn-specific IgG antibodies in deceased patients [7]. Previous studies on SFTS-specific virus kinetics have typically focused on NP-specific antibodies [10,11,12,13], and are limited owing to their singlecenter study design. We investigated anti-Gn-specific antibody kinetics in patients with SFTS, as well as viral load and cytokine profiles, through a multicenter prospective study in South Korea
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