Autor(es): Calvet Guilherme, Aguiar Renato S, Melo Adriana S O, Sampaio Simone A, de Filippis Ivano, Fabri Allison, Araujo Eliane S M, de Sequeira Patricia C, de Mendonça Marcos C L, de Oliveira Louisi, Tschoeke Diogo A, Schrago Carlos G, Thompson Fabiano L, Brasil Patricia, Dos Santos Flavia B, Nogueira Rita M R, Tanuri Amilcar, de Filippis Ana M B

Resumo: The incidence of microcephaly in Brazil in 2015 was 20 times higher than in previous years. Congenital microcephaly is associated with genetic factors - several causative agents. Epidemiological data suggest that microcephaly cases in Brazil might be associated with the introduction of Zika virus. We aimed to detect - sequence the Zika virus genome in amniotic fluid samples of two pregnant women in Brazil whose fetuses were diagnosed with microcephaly. In this case study, amniotic fluid samples from two pregnant women from the state of Paraíba in Brazil whose fetuses had been diagnosed with microcephaly were obtained, on the recommendation of the Brazilian health authorities, by ultrasound-guided transabdominal amniocentesis at 28 weeks' gestation. The women had presented at 18 weeks' - 10 weeks' gestation, respectively, with clinical manifestations that could have been symptoms of Zika virus infection, including fever, myalgia, - rash. After the amniotic fluid samples were centrifuged, DNA - RNA were extracted from the purified virus particles before the viral genome was identified by quantitative reverse transcription PCR - viral metagenomic next-generation sequencing. Phylogenetic reconstruction - investigation of recombination events were done by comparing the Brazilian Zika virus genome with sequences from other Zika strains - from flaviviruses that occur in similar regions in Brazil. We detected the Zika virus genome in the amniotic fluid of both pregnant women. The virus was not detected in their urine or serum. Tests for dengue virus, chikungunya virus, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus, HIV, Treponema pallidum, - parvovirus B19 were all negative. After sequencing of the complete genome of the Brazilian Zika virus isolated from patient 1, phylogenetic analyses showed that the virus shares 97-100% of its genomic identity with lineages isolated during an outbreak in French Polynesia in 2013, - that in both envelope - NS5 genomic regions, it clustered with sequences from North - South America, southeast Asia, - the Pacific. After assessing the possibility of recombination events between the Zika virus - other flaviviruses, we ruled out the hypothesis that the Brazilian Zika virus genome is a recombinant strain with other mosquito-borne flaviviruses. These findings strengthen the putative association between Zika virus - cases of microcephaly in neonates in Brazil. Moreover, our results suggest that the virus can cross the placental barrier. As a result, Zika virus should be considered as a potential infectious agent for human fetuses. Pathogenesis studies that confirm the tropism of Zika virus for neuronal cells are warranted. Consellho Nacional de Desenvolvimento e Pesquisa (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ).

Imprenta: The Lancet. Infectious Diseases, v. 16, n. 6, p. 653-660, 2016

Identificador do Objeto Digital: 10.1016/S1473-3099(16)00095-5

Descritores: Chikungunya virus - Cell ; Chikungunya virus - DNA ; Chikungunya virus - Genome ; Chikungunya virus - Pathogenesis ; Chikungunya virus - RNA ; Chikungunya virus - PCR detection ; Chikungunya Virus - Virus ; Chikungunya virus - Chikungunya fever ; Chikungunya virus - Dengue ; Chikungunya virus - Microcephaly ; Chikungunya virus - Zika fever

Data de Publicação: 2016