{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T03:14:00Z","timestamp":1789269240434,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sao Paulo Research Foundation","award":["2016\/01735-2"],"award-info":[{"award-number":["2016\/01735-2"]}]},{"name":"Sao Paulo Research Foundation","award":["2019\/13713-1"],"award-info":[{"award-number":["2019\/13713-1"]}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Yellow fever is a mosquito-borne zoonotic disease caused by yellow fever virus (YFV). Between 2017 and 2019, more than 504 human cases and 176 deaths were confirmed in the outskirts of S\u00e3o Paulo city. Throughout this outbreak, studies suggested a potential association between YFV viremia and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Viral ribonucleic acid was measured using reverse-transcription quantitative polymerase chain reaction in plasma samples collected at up to 5 time points, between 3 and 120 days after symptoms onset.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eighty-four patients with confirmed YFV infection were included. Most were males, median age was 42, and 30 (36%) died. Deceased patients were older than survivors (P = .003) and had a higher viremia across all time points (P = .0006). Mean values of viremia had a positive, statistically significant correlation with peak values of neutrophils, indirect bilirubin, aspartate transaminase, international normalized ratio, and creatinine. Finally, a Cox proportional hazards model adjusted for age and laboratory variables showed that viremia is independently associated with death, with a mean 1.84-fold increase (84%) in the hazard of death (P &amp;lt; .001) for each unit increase in mean log10 viremia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results raise the importance of monitoring YFV viremia and suggest a potential benefit of antiviral drugs or neutralizing monoclonal antibodies early in the course of this infection to improve disease outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiac435","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T04:37:59Z","timestamp":1667277479000},"page":"1097-1103","source":"Crossref","is-referenced-by-count":10,"title":["Viral Kinetics in Sylvatic Yellow Fever Cases"],"prefix":"10.1093","volume":"227","author":[{"given":"Vivian I","family":"Avelino-Silva","sequence":"first","affiliation":[{"name":"Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Vailant","family":"Thomazella","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Prado","family":"Marmorato","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4526-0896","authenticated-orcid":false,"given":"Carolina A","family":"Correia","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Z C","family":"Dias","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvino","family":"Maestri","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia B","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H V","family":"Moreira","sequence":"additional","affiliation":[{"name":"Institute of Infectology \u201cEmilio Ribas\u201d , S\u00e3o Paulo, SP, 01246-900 , Brazil"},{"name":"Institute of Tropical Medicine, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Buccheri","sequence":"additional","affiliation":[{"name":"Institute of Infectology \u201cEmilio Ribas\u201d , S\u00e3o Paulo, SP, 01246-900 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvina C","family":"F\u00e9lix","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine, Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 05403-000 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz G F A B E","family":"Zanella","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla R","family":"Costa","sequence":"additional","affiliation":[{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esper G","family":"Kall\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 05403-000 , Brazil"},{"name":"Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo, SP, 1246-903 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"key":"2023042618004278000_jiac435-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41541-020-0205-6","article-title":"Review of data and knowledge gaps regarding yellow fever vaccine-induced immunity and duration of protection","volume":"5","author":"Staples","year":"2020","journal-title":"NPJ Vaccines"},{"key":"2023042618004278000_jiac435-B2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.jcv.2014.08.030","article-title":"Yellow fever","volume":"64","author":"Monath","year":"2015","journal-title":"J Clin Virol"},{"key":"2023042618004278000_jiac435-B3","doi-asserted-by":"crossref","first-page":"e180278","DOI":"10.1590\/0074-02760180278","article-title":"Yellow fever outbreak in Brazil: the puzzle of rapid viral spread and challenges for immunisation","volume":"113","author":"Possas","year":"2018","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"2023042618004278000_jiac435-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40794-020-0101-0","article-title":"Yellow fever control: current epidemiology and vaccination strategies","volume":"6","author":"Chen","year":"2020","journal-title":"Trop Dis Travel Med Vaccines"},{"key":"2023042618004278000_jiac435-B5"},{"key":"2023042618004278000_jiac435-B6","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S1473-3099(19)30125-2","article-title":"Predictors of mortality in patients with yellow fever: an observational cohort study","volume":"19","author":"Kall\u00e1s","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2023042618004278000_jiac435-B7","doi-asserted-by":"crossref","first-page":"e027207","DOI":"10.1136\/bmjopen-2018-027207","article-title":"Efficacy of sofosbuvir as treatment for yellow fever: protocol for a randomised controlled trial in Brazil (SOFFA study)","volume":"9","author":"Figueiredo-Mello","year":"2019","journal-title":"BMJ Open"},{"key":"2023042618004278000_jiac435-B8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007072","article-title":"Yellow fever virus is susceptible to sofosbuvir both in vitro and in vivo","volume":"13","author":"de Freitas","year":"2019","journal-title":"PLoS Negl Trop Dis"},{"key":"2023042618004278000_jiac435-B9","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.aohep.2019.09.001","article-title":"Sofosbuvir inhibits yellow fever virus in vitro and in patients with acute liver failure","volume":"18","author":"Mendes","year":"2019","journal-title":"Ann Hepatol"},{"key":"2023042618004278000_jiac435-B10","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/taz040","article-title":"Severe yellow fever in Brazil: clinical characteristics and management","volume":"26","author":"Ho","year":"2019","journal-title":"J Travel Med"},{"key":"2023042618004278000_jiac435-B11","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.4161\/21645515.2014.990854","article-title":"New approaches for the standardization and validation of a real-time qPCR assay using TaqMan probes for quantification of yellow fever virus on clinical samples with high quality parameters","volume":"11","author":"Fernandes-Monteiro","year":"2015","journal-title":"Hum Vaccin Immunother"},{"key":"2023042618004278000_jiac435-B12","doi-asserted-by":"crossref","DOI":"10.1128\/JCM.00827-18","article-title":"Yellow fever virus: diagnostics for a persistent arboviral threat","volume":"56","author":"Waggoner","year":"2018","journal-title":"J Clin Microbiol"},{"key":"2023042618004278000_jiac435-B13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-021-06535-4","article-title":"Estimating case fatality risk of severe yellow fever cases: systematic literature review and meta-analysis","volume":"21","author":"Servadio","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2023042618004278000_jiac435-B14","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ijid.2020.01.039","article-title":"Clinical profiles and factors associated with mortality in adults with yellow fever admitted to an intensive care unit in minas gerais, Brazil","volume":"93","author":"de \u00c1vila","year":"2020","journal-title":"Int J Infect Dis"},{"key":"2023042618004278000_jiac435-B15","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.trstmh.2006.04.001","article-title":"Clinical and epidemiological characteristics of yellow fever in Brazil: analysis of reported cases 1998\u20132002","volume":"101","author":"Tuboi","year":"2007","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2023042618004278000_jiac435-B16","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1006\/viro.2002.1704","article-title":"High levels of plasma dengue viral load during defervescence in patients with dengue hemorrhagic fever: implications for pathogenesis","volume":"305","author":"Wang","year":"2003","journal-title":"Virology"},{"key":"2023042618004278000_jiac435-B17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13071-014-0590-7","article-title":"Evaluation of host and viral factors associated with severe dengue based on the 2009 WHO classification","volume":"7","author":"Pozo-Aguilar","year":"2014","journal-title":"Parasit Vectors"},{"key":"2023042618004278000_jiac435-B18","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3923\/jms.2020.49.54","article-title":"Relationship of viral load toward platelet count and hematocrit level in DENV-2 infection","volume":"20","author":"Almurdi","year":"2020","journal-title":"J Med Sci"},{"key":"2023042618004278000_jiac435-B19","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1016\/j.jiph.2021.10.002","article-title":"High viral load positively correlates with thrombocytopenia and elevated haematocrit in dengue infected paediatric patients","volume":"14","author":"Pathak","year":"2021","journal-title":"J Infect Public Health"},{"key":"2023042618004278000_jiac435-B20","first-page":"1","article-title":"Severe multiorgan failure following yellow fever vaccination","volume":"8","author":"Domingo","year":"2020","journal-title":"Vaccines (Basel)"},{"key":"2023042618004278000_jiac435-B21","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.virol.2005.09.058","article-title":"Revisiting the liver in human yellow fever: virus-induced apoptosis in hepatocytes associated with TGF-beta, TNF-alpha and NK cells activity","volume":"345","author":"Quaresma","year":"2006","journal-title":"Virology"}],"container-title":["The Journal of Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jid\/advance-article-pdf\/doi\/10.1093\/infdis\/jiac435\/47257662\/jiac435.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/227\/9\/1097\/50100901\/jiac435.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jid\/article-pdf\/227\/9\/1097\/50100901\/jiac435.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T18:03:28Z","timestamp":1682532208000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jid\/article\/227\/9\/1097\/6783203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,11,1]]},"published-print":{"date-parts":[[2023,4,26]]}},"URL":"https:\/\/doi.org\/10.1093\/infdis\/jiac435","relation":{},"ISSN":["0022-1899","1537-6613"],"issn-type":[{"value":"0022-1899","type":"print"},{"value":"1537-6613","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2022,11,1]]}}}