A 40 months follow-up of Ebola virus disease survivors in Guinea (Postebogui) reveals longterm detection of Ebola viral RNA in semen and breast milk

• Published in: Open forum infectious diseases
• Main Authors: Keita, Alpha Kabinet, Vidal, Nicole, Toure, Abdoulaye, Diallo, Mamadou Saliou Kalifa, Magassouba, N’Fally, Baize, Sylvain, Mateo, Mathieu, Raoul, Herve, Mely, Stephane, Subtil, Fabien, Kpamou, Cécé, Koivogui, Lamine, Traore, Falaye, Sow, Mamadou Saliou, Ayouba, Ahidjo, Etard, Jean Francois, Delaporte, Eric, Peeters, Martine
• Format: Journal Article
• Language: English
• Published: 08.11.2019
• ISSN: 2328-8957; 2328-8957
• DOI: 10.1093/ofid/ofz482

Abstract Background With the increasing frequency and impact of Ebola virus disease (EVD) outbreaks illustrated by recent epidemics, good knowledge on extent of viral persistance or RNA detection in body fluids from survivors is urgently needed. Methods Ebola viral RNA shedding was studied with molecular assays in semen (n=1,368), urine (n=1,875), cervico-vaginal fluid (n=549), saliva (n=900), breast milk (n=168) and feces (n=558) from EVD survivors in Guinea (POSTEBOGUI cohort, n=802) at a regular base until 40 months after inclusion. Results 27/277 (9.8%) male survivors tested positive for Ebola RNA in at least one semen sample. The probability of remaining positive for Ebola RNA in semen was estimated at 93.02% and 60.12% after three and six months. Viral RNA in semen was more frequent in patients with eye pain (p=0.036), joint pain (p=0.047), and higher antibody levels to Ebola virus antigens (NP (p=0.001), GP (p=0.05) and VP40 (p=0.05)). Ebola RNA was only rarely detected in other body fluids from EVD survivors : saliva (1/454) urine (2/593), breast milk (2/168), cervico-vaginal secretions (0/273), feces (0/330). RNA was detected in breast milk one month after delivery but 500 days after discharge of Ebola treatment unit (ETU) in a women who became pregnant seven months after discharge from the ETU. Conclusions The frequency and potential long term presence of viral RNA in semen confirm that systematic prevention measures in male survivors are required. Our observation in breast milk suggest that our knowledge on viral reservoir in immune priveledged sites and its impact are still incomplete.