Prevalence and Correlates of Zinc Deficiency in Dengue Virus Infection
Trumbull-Kennedy, Meghan Mary
Zinc is a known immunomodulator, yet there is limited literature on zinc deficiency or its role in the context of most arboviral infections, including Dengue virus infection (DENV). This study describes the prevalence of zinc deficiency and its associations with immune response markers in participants with and those exposed to DENV. We quantified the zinc status of a convenient subset of participants (n=71), who had available adequate sample volumes, from an arbovirus surveillance program in Ecuador. Data on anthropometry, demographics, clinical history, and immune response markers for participants was available through the parent surveillance program and earlier studies. Participants were categorized by the presence of nonstructural protein 1(NS1 antigen), IgM, and IgG for one of four DENV serotypes into one of the following categories: Healthy Controls, Non-Febrile DENV, Other Febrile Illness, and Apparent DENV. Associations between zinc status and covariates were explored using linear and logistic regression in SAS 9.4 (SAS Institute, Cary, NC). Significance testing to compare observations across illness categories was performed using ANOVA with a post hoc Tukey test, with results presented as mean and standard deviation. The average age of the sample population was 31.5±15.0 years. The prevalence of zinc deficiency (serum zinc≤ 65 µg/dL) in the study population was 30%. Using multivariate methods, CXCL10 concentrations, age, and sex were found to be significantly associated with serum zinc, with increasing levels of CXCL10 associated with greater odds of zinc deficiency. Serum zinc concentrations varied significantly across illness categories (p<0.01), with the symptomatic groups having the lowest mean serum zinc concentrations (SMD=1.27). This exploratory analysis adds evidence for a potential association between zinc status and the expression of CXCL10 that needs to be investigated in future longitudinal studies. Further, while the importance of zinc for optimal immune function has been well established, the effect of zinc status on the immune response and DENV pathogenesis remains to be fully described.
Dengue Virus Infection; Nutrition; Zinc
Master of Science
Attribution-NonCommercial-NoDerivatives 4.0 International
dissertation or thesis
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