Persistence and clearance of Ebola virus RNA from seminal fluid of Ebola virus disease survivors: a longitudinal analysis and modelling study

Sissoko, Daouda and Duraff our, Sophie and Kerber, Romy and Seraphin Kolie, Jacques and Habib Beavogui, Abdou and Camara, Alseny-Modet and Colin, Géraldine and Rieger, Toni and Oestereich, Lisa and Pályi, Bernadett and Wurr, Stephanie and Guedj, Jeremie and Tram Nguyen, Thi Huyen and M Eggo, Rosalind and H Watson, Conall and Edmunds, W John and Akoi Bore, Joseph and Raymond Koundouno, Fara and Cabeza-Cabrerizo, Mar and L Carter, Lisa and Eleni Kafetzopoulou, Liana and Kuisma, Eeva and Michel, Janine and Victoria Patrono, Livia and Y Rickett, Natasha and Singethan, Katrin and Rudolf, Martin and Lander, Angelika and Pallasch, Elisa and Bockholt, Sabrina and Rodríguez, Estefanía and Di Caro, Antonino and Wölfel, Roman and Gabriel, Martin and Gurry, Céline and Formenty, Pierre and Keïta, Sakoba and Malvy, Denis and W Carroll, Miles and Anglaret, Xavie and Günther, Stephan (2017) Persistence and clearance of Ebola virus RNA from seminal fluid of Ebola virus disease survivors: a longitudinal analysis and modelling study. The Lancet Global Health, 5 (1). e80-e88. ISSN 0140-6736


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Background By January, 2016, all known transmission chains of the Ebola virus disease (EVD) outbreak in west Africa had been stopped. However, there is concern about persistence of Ebola virus in the reproductive tract of men who have survived EVD. We aimed to use biostatistical modelling to describe the dynamics of Ebola virus RNA load in seminal fl uid, including clearance parameters. Methods In this longitudinal study, we recruited men who had been discharged from three Ebola treatment units in Guinea between January and July, 2015. Participants provided samples of seminal fl uid at follow-up every 3–6 weeks, which we tested for Ebola virus RNA using quantitative real-time RT-PCR. Representative specimens from eight participants were then inoculated into immunodefi cient mice to test for infectivity. We used a linear mixed-eff ect model to analyse the dynamics of virus persistence in seminal fl uid over time. Findings We enrolled 26 participants and tested 130 seminal fl uid specimens; median follow up was 197 days (IQR 187–209 days) after enrolment, which corresponded to 255 days (228–287) after disease onset. Ebola virus RNA was detected in 86 semen specimens from 19 (73%) participants. Median duration of Ebola virus RNA detection was 158 days after onset (73–181; maximum 407 days at end of follow-up). Mathematical modelling of the quantitative time-series data showed a mean clearance rate of Ebola virus RNA from seminal fl uid of –0·58 log units per month, although the clearance kinetic varied greatly between participants. Using our biostatistical model, we predict that 50% and 90% of male survivors clear Ebola virus RNA from seminal fl uid at 115 days (90% prediction interval 72–160) and 294 days (212–399) after disease onset, respectively. We also predicted that the number of men positive for Ebola virus RNA in aff ected countries would decrease from about 50 in January 2016, to fewer than 1 person by July, 2016. Infectious virus was detected in 15 of 26 (58%) specimens tested in mice. Interpretation Time to clearance of Ebola virus RNA from seminal fl uid varies greatly between individuals and could be more than 13 months. Our predictions will assist in decision-making about surveillance and preventive measures in EVD outbreaks.

Item Type: Article
Subjects: WA Public Health
Divisions: Faculty of Medicin
Depositing User: Touba Derakhshande
Date Deposited: 17 Sep 2017 06:24
Last Modified: 17 Sep 2017 06:24

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