{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:36:19Z","timestamp":1785443779481,"version":"3.56.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Vaccine Immunol."],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>To estimate the susceptibility to enterovirus infection and the frequency of long-term poliovirus excreters in Tunisian patients with primary immunodeficiencies (PIDs), enteroviruses were assessed in stool specimens of 82 patients with humoral, combined, and other PIDs. Isolated viruses were typed and intratyped by standard molecular techniques, and the whole VP1 region of poliovirus isolates was sequenced. Polioviruses were detected in 6 patients; all isolates were vaccine related. Five patients rapidly stopped excretion; one excreted a poliovirus type 1 isolate for several months, and the isolate accumulated up to 14 mutations in the VP1 region. Nonpolio enteroviruses were identified in 6 patients; 4 of them kept excreting the same strain for more than 6 months. The rate of enterovirus infection was 13.4% of the PID patients and 20.7% of those with an IgG defect; it greatly exceeded the rates generally found in Tunisian supposed-immunocompetent individuals (4.1% during the study period;<jats:italic>P<\/jats:italic>= 0.001 and<jats:italic>P<\/jats:italic>&lt; 0.0001, respectively). Interestingly, patients with combined immunodeficiencies were at a higher risk for enterovirus infection than those with an exclusively B cell defect. A major histocompatibility complex (MHC) class II antigen expression defect was found in 54% of enterovirus-positive patients and in the unique long-term poliovirus excreter. The study results also suggest that substitutive immunoglobulin therapy may help clearance of a poliovirus infection and that most PID patients have the ability to stop poliovirus excretion within a limited period. However, the high susceptibility of these patients to enterovirus infection reinforces the need for enhanced surveillance of these patients until the use of oral poliovirus vaccine (OPV) is stopped.<\/jats:p>","DOI":"10.1128\/cvi.00293-12","type":"journal-article","created":{"date-parts":[[2012,8,23]],"date-time":"2012-08-23T00:36:59Z","timestamp":1345682219000},"page":"1684-1689","source":"Crossref","is-referenced-by-count":34,"title":["High Susceptibility for Enterovirus Infection and Virus Excretion Features in Tunisian Patients with Primary Immunodeficiencies"],"prefix":"10.1128","volume":"19","author":[{"given":"Nadia","family":"Driss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Ben-Mustapha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fethi","family":"Mellouli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahlem","family":"Ben Yahia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henda","family":"Touzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bejaoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Ben Ghorbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henda","family":"Triki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed-Ridha","family":"Barbouche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2012,8,22]]},"reference":[{"key":"key20180919073627_B1","doi-asserted-by":"crossref","first-page":"S176","DOI":"10.1093\/infdis\/175.Supplement_1.S176","article-title":"Duration of poliovirus excretion and its implications for acute flaccid paralysis surveillance: a review of the literature","volume":"175","author":"Alexander","year":"1997","journal-title":"J. Infect. Dis."},{"key":"key20180919073627_B2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1099\/jmm.0.45695-0","article-title":"Enteroviruses in Tunisia: virological surveillance over 12 years (1992\u20132003)","volume":"54","author":"Bahri","year":"2005","journal-title":"J. Med. Microbiol."},{"key":"key20180919073627_B3","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1128\/JCM.38.2.552-557.2000","article-title":"Genomic variations in echovirus 30 persistent isolates recovered from a chronically infected immunodeficient child and comparison with the reference strain","volume":"38","author":"Bailly","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"key20180919073627_B4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1749-6632.2011.06260.x","article-title":"Primary immunodeficiencies in highly consanguineous North African populations","volume":"1238","author":"Barbouche","year":"2011","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"key20180919073627_B5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1006\/viro.1999.0003","article-title":"Evolution of poliovirus type I during 5.5 years of prolonged enteral replication in an immunodeficient patient","volume":"265","author":"Bellmunt","year":"1999","journal-title":"Virology"},{"key":"key20180919073627_B6","doi-asserted-by":"crossref","first-page":"2819","DOI":"10.1099\/vir.0.19127-0","article-title":"Pathogenesis of poliovirus infection in PVRTg mice: poliovirus replicates in peritoneal macrophages","volume":"84","author":"Buisman","year":"2003","journal-title":"J. Gen. Virol."},{"key":"key20180919073627_B7","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1099\/vir.0.18974-0","article-title":"Nucleotide variation in Sabin type 2 poliovirus from an immunodeficient patient with poliomyelitis","volume":"84","author":"Buttinelli","year":"2003","journal-title":"J. Gen. Virol."},{"key":"key20180919073627_B8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.clim.2003.11.011","article-title":"Search for poliovirus long-term excretors among patients affected by agammaglobulinemia","volume":"111","author":"Fiore","year":"2004","journal-title":"Clin. Immunol."},{"key":"key20180919073627_B9","doi-asserted-by":"crossref","first-page":"7381","DOI":"10.1128\/JVI.74.16.7381-7390.2000","article-title":"Evolution of circulating wild poliovirus and of vaccine-derived poliovirus in an immunodeficient patient: a unifying model","volume":"74","author":"Gavrilin","year":"2000","journal-title":"J. Virol."},{"key":"key20180919073627_B10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jcv.2007.10.002","article-title":"Genetic features of polioviruses isolated in Tunisia, 1991\u20132006","volume":"41","author":"Haddad-Boubaker","year":"2008","journal-title":"J. Clin. Virol."},{"key":"key20180919073627_B11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1053\/jinf.2002.1066","article-title":"Enteroviral infections in primary immunodeficiency (PID): a survey of morbidity and mortality","volume":"46","author":"Halliday","year":"2003","journal-title":"J. Infect."},{"key":"key20180919073627_B12","first-page":"3","article-title":"Search for poliovirus carriers among people with primary immune deficiency diseases in the United States, Mexico, Brazil, and the United Kingdom","volume":"82","author":"Halsey","year":"2004","journal-title":"Bull. World Health Organ."},{"key":"key20180919073627_B13","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1128\/JCM.36.10.2893-2899.1998","article-title":"Prolonged replication of a type 1 vaccine-derived poliovirus in an immunodeficient patient","volume":"36","author":"Kew","year":"1998","journal-title":"J. Clin. Microbiol."},{"key":"key20180919073627_B14","first-page":"16","article-title":"Circulating vaccine-derived polioviruses: current state of knowledge","volume":"82","author":"Kew","year":"2004","journal-title":"Bull. World Health Organ"},{"key":"key20180919073627_B15","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1086\/379791","article-title":"Persistence of vaccine-derived polioviruses among immunodeficient persons with vaccine-associated paralytic poliomyelitis","volume":"188","author":"Khetsuriani","year":"2003","journal-title":"J. Infect. Dis."},{"key":"key20180919073627_B16","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.1128\/JCM.00702-09","article-title":"Rapid group-, serotype-, and vaccine strain-specific identification of poliovirus isolates by real-time reverse transcription-PCR using degenerate primers and probes containing deoxyinosine residues","volume":"47","author":"Kilpatrick","year":"2009","journal-title":"J. Clin. Microbiol."},{"key":"key20180919073627_B17","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1099\/vir.0.79919-0","article-title":"Gut-homing (alpha(4)beta(7)(+)) Th1 memory responses after inactivated poliovirus immunization in poliovirus orally pre-immunized donors","volume":"85","author":"Krieg","year":"2004","journal-title":"J. Gen. Virol."},{"key":"key20180919073627_B18","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/S0140-6736(04)16150-3","article-title":"Failure to clear persistent vaccine-derived neurovirulent poliovirus infection in an immunodeficient man","volume":"363","author":"MacLennan","year":"2004","journal-title":"Lancet"},{"key":"key20180919073627_B19","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1084\/jem.181.4.1285","article-title":"Poliovirus-specific CD4+ Th1 clones with both cytotoxic and helper activity mediate protective humoral immunity against a lethal poliovirus infection in transgenic mice expressing the human poliovirus receptor","volume":"181","author":"Mahon","year":"1995","journal-title":"J. Exp. Med."},{"key":"key20180919073627_B20","doi-asserted-by":"crossref","first-page":"3001","DOI":"10.1128\/JVI.74.7.3001-3010.2000","article-title":"Evolution of the Sabin strain of type 3 poliovirus in an immunodeficient patient during the entire 637-day period of virus excretion","volume":"74","author":"Mart\u00edn","year":"2000","journal-title":"J. Virol."},{"key":"key20180919073627_B21","first-page":"21","article-title":"Advantages and disadvantages of killed and live poliomyelitis vaccines","volume":"56","author":"Melnick","year":"1978","journal-title":"Bull. World Health Organ."},{"key":"key20180919073627_B22","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1016\/j.vaccine.2009.02.071","article-title":"Vaccine-derived poliovirus (VDPV): impact on poliomyelitis eradication","volume":"27","author":"Minor","year":"2009","journal-title":"Vaccine"},{"key":"key20180919073627_B23","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1093\/aje\/kwq320","article-title":"From emergence to eradication: the epidemiology of poliomyelitis deconstructed","volume":"172","author":"Nathanson","year":"2010","journal-title":"Am. J. Epidemiol."},{"issue":"2","key":"key20180919073627_B24","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jcv.2007.04.002","article-title":"Vaccine-associated paralytic poliomyelitis in a patient with MHC class II deficiency","volume":"39","author":"Parvaneh","year":"2007","journal-title":"J. Clin. Virol."},{"key":"key20180919073627_B25","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/jmv.10579","article-title":"Molecular characterization of coxsackievirus B5 isolates","volume":"72","author":"Rezig","year":"2004","journal-title":"J. Med. Virol."},{"key":"key20180919073627_B26","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.virusres.2008.07.006","article-title":"Isolation of a type 3 vaccine-derived poliovirus (VDPV) from an Iranian child with X-linked agammaglobulinemia","volume":"137","author":"Shahmahmoodi","year":"2008","journal-title":"Virus Res."},{"key":"key20180919073627_B27","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1128\/JCM.41.3.1203-1211.2003","article-title":"Community-acquired poliovirus infection in children with primary immunodeficiencies in Tunisia","volume":"41","author":"Triki","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"key20180919073627_B28","article-title":"Manual for the virological investigation of poliomyelitis","volume-title":"WHO\/EPI\/GEN\/04","author":"WHO","year":"2004"},{"key":"key20180919073627_B29","first-page":"347","article-title":"Stopping poliovirus vaccination after eradication: issues and challenges","volume":"78","author":"Wood","year":"2000","journal-title":"Bull. World Health Organ."},{"key":"key20180919073627_B30","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1046\/j.1440-1754.2003.00263.x","article-title":"Towards global poliomyelitis eradication: the successes and challenges for a developed country","volume":"39","author":"Wood","year":"2003","journal-title":"J. Paediatr. Child Health"}],"container-title":["Clinical and Vaccine Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1128\/CVI.00293-12","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T20:46:41Z","timestamp":1627591601000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/CVI.00293-12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,8,22]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2012,9,26]]},"published-print":{"date-parts":[[2012,10]]}},"alternative-id":["10.1128\/CVI.00293-12"],"URL":"https:\/\/doi.org\/10.1128\/cvi.00293-12","relation":{},"ISSN":["1556-6811","1556-679X"],"issn-type":[{"value":"1556-6811","type":"print"},{"value":"1556-679X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8,22]]}}}