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Clearing Vaccine-Derived Poliovirus Infection Following Hematopoietic Stem Cell Transplantation: a Case Report and Review of Literature

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Abstract

The use of oral poliovirus vaccine in a worldwide scale has led to a 99.9% decrease in annual incidence of wild-type poliomyelitis and the eradication of serotype 2 poliovirus. However, the emergence of vaccine-derived polioviruses (VDPVs) is endangering the eradication program. Patients with combined immunodeficiencies are at increased risk of both vaccine-associated poliomyelitis and prolonged asymptomatic infection with immunodeficiency-associated VDPVs (iVDPVs). Herein, we present a severe combined immunodeficiency patient with prolonged and asymptomatic iVDPV infection. He continued to shed poliovirus during immunoglobulin replacement therapy and cleared the infection following successful hematopoietic stem cell transplantation (HSCT). To explain the efficiency of HSCT in clearing the infection, we reviewed the literature for all reports of HSCT in iVDPV-excreting patients and discussed novel ideas about the role of different immune mechanisms, including cell-mediated interactions, in mounting immune responses against poliovirus infections. This study could provide further insights into the immune mechanisms contributing to the clearance of enteroviral infections.

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Acknowledgments

We thank Ahmad Nejati, Maryam Yousefi, Yaghoob Mollaie, and all the staff members of the Iran National Polio Laboratory and also CDC-Atlanta for performing thorough virologic studies.

This study was done at the Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran. The Iran National Polio Laboratory is supported by the Ministry of Health and Medical Education, the World Health Organization, and Tehran University of Medical Sciences.

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Authors and Affiliations

  1. Research Center for Immunodeficiencies, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Mohammadreza Shaghaghi, Mona Irannejad, Hassan Abolhassani, Reza Yazdani & Asghar Aghamohammadi

  2. Network of Immunology in Infections, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Mohammadreza Shaghaghi

  3. Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden

    Hassan Abolhassani

  4. Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Shohreh Shahmahmoodi

  5. Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Shohreh Shahmahmoodi

  6. Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Amir Ali Hamidieh

  7. Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Saeed Soleyman-Jahi

  8. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Gholamreza Azizi

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  1. Mohammadreza Shaghaghi
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  2. Mona Irannejad
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  3. Hassan Abolhassani
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  4. Shohreh Shahmahmoodi
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  5. Amir Ali Hamidieh
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  7. Reza Yazdani
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  8. Gholamreza Azizi
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  9. Asghar Aghamohammadi
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Correspondence to Asghar Aghamohammadi.

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Shaghaghi, M., Irannejad, M., Abolhassani, H. et al. Clearing Vaccine-Derived Poliovirus Infection Following Hematopoietic Stem Cell Transplantation: a Case Report and Review of Literature. J Clin Immunol 38, 610–616 (2018). https://doi.org/10.1007/s10875-018-0521-z

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