Abstract
Long-term follow up studies from Ebola virus disease (EVD) survivors (EBOV_S) are lacking. Here, we evaluate immune and gene expression profiles in 35 Guinean EBOV_S from the last West African outbreak, a median of 23 months (IQR [18–25]) after discharge from treatment center. Compared with healthy donors, EBOV_S exhibit increases of blood markers of inflammation, intestinal tissue damage, T cell and B cell activation and a depletion of circulating dendritic cells. All survivors have EBOV-specific IgG antibodies and robust and polyfunctional EBOV-specific memory T-cell responses. Deep sequencing of the genes expressed in blood reveals an enrichment in ‘inflammation’ and ‘antiviral’ pathways. Integrated analyses identify specific immune markers associated with the persistence of clinical symptoms. This study identifies a set of biological and genetic markers that could be used to define a signature of “chronic Ebola virus disease (CEVD)”.
Highlights
Long-term follow up studies from Ebola virus disease (EVD) survivors (EBOV_S) are lacking
In the 2013–2016 West African outbreak, Ebola virus infected more than 28,000 people, causing 11,310 deaths by May 11, 2016, in six countries (Sierra Leone, Liberia, Guinea, Mali, Nigeria, and Senegal)[1,2]
No of participants Median age Sex Median time from Ebola treatment center (ETC) discharge to inclusion EBOV RT-PCRa Clinical eventsb All symptoms Joint pain Fatigue Ocular disorders Headache Muscle pain Fever Abdominal pain Anorexia
Summary
Long-term follow up studies from Ebola virus disease (EVD) survivors (EBOV_S) are lacking. In the most affected countries, unprecedented follow-up of large numbers of Ebola virus disease (EVD) survivors (EBOV_S) has revealed long-term clinical sequelae. Two large cohorts of survivors from the West African outbreak have been reported[3,4,5] Their clinical follow-up revealed symptom persistence >1 year after acute EVD (Prevail III cohort) or discharge from the Ebola treatment center (ETC) (Postebogui cohort). At inclusion, many patients presented symptoms similar to those experienced during acute-phase infection, suggesting the persistence or recurrence of a pathogenic process These studies, and smaller previous case series[6,7,8,9], have refined definitions of the clinical spectrum of post-EVD sequelae
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