Characteristics of serological profile in adult measles patients depending on the development of complications
Keywords:measles in adults, serological tests, complications
The aim – to determine the characteristics of serological profile in adult measles patients depending on the development of complications.
Material and methods. In total, 88 patients with measles aged between 21 and 53 years were followed-up (36 men and 52 women). Measles was diagnosed according to the WHO criteria (2013). All the patients were tested for measles virus IgM at the end of the first week of the disease to confirm the diagnosis. Measles IgG was measured using ELISA (Vircell Microbiologists,Spain) on hospital admission, on average the (4.8 ± 0.2) day of the disease, to determine probable post-vaccination immunity to measles.
Results. It was found that in most adult measles patients (75.0 %), the diagnosis was confirmed by the detection of IgM to measles virus at the end of the first week of the disease, while the other patients were diagnosed with measles by clinical and epidemiological criteria.
Most patients (71.6 %) were seropositive with the presence of measles virus IgG on the 4.8 ± 0.2 day of the disease, others had a negative IgG serologic result. Complications of measles were diagnosed in the majority of adult patients (76.1 %), the frequency of which was associated (χ2 = 4.84, P < 0.01) with seropositivity in this follow-up period, namely complications were more common in the seronegative patients (92.0 %) against 69.8 % in the seropositive patients. Seronegative patients were more likely to have gastrointestinal complications as compared to seropositive individuals (68.0 % vs. 30.2 %, χ2 = 10.60, P < 0.001) due to more frequent development of hepatitis (68.0 % vs. 28.6 %, χ2 = 11.61, P < 0.001). The frequency of two or more complications combined was also clearly correlated with the presence of measles virus IgG in patients on day 4.8 ± 0.2 of the disease (χ2 = 7.70, P < 0.01).
A comparison of the quantitative content of IgG against measles virus in seropositive adult measles patients showed an association with the development of complications: the highest level was detected in patients with uncomplicated measles amounting to 23.58 [21.87; 26.78] optical density units. In seropositive adult patients with measles-associated hepatitis, the measles virus IgG content was lower (P = 0.004) than that in patients with uncomplicated measles. A similar pattern was observed in pneumonia development (P = 0.0002). There were correlations between measles virus IgG content and platelet count (r = +0.32, P < 0.05), relative number of lymphocytes (r = +0.46, P < 0.05), ALT activity (r = -0.45, P < 0.05), relative number of band neutrophils (r = -0.36, P < 0.05).
Conclusions. In adult measles patients on day 4.8 ± 0.2 of the disease, seropositivity with measles virus IgG presence was observed in 71.6 % of cases. Measles complications were recorded in 76.1 % of adult patients. The incidence of complications was correlated with the presence of IgG against measles virus. Complications were more common in seronegative patients than in seropositive ones (92.0 % vs. 69.8 %, P < 0.01). The development of pneumonia (P < 0.01) and hepatitis (P < 0.01) was associated with the lowest level of measles virus IgG.
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