1
|
Dépéry L, Bally I, Amen A, Némoz B, Buisson M, Grossi L, Truffot A, Germi R, Guilligay D, Veloso M, Vilotitch A, Epaulard O, Morand P, Weissenhorn W, Poignard P, Lupo J. Anti-SARS-CoV-2 serology based on ancestral RBD antigens does not correlate with the presence of neutralizing antibodies against Omicron variants. Microbiol Spectr 2025; 13:e0156824. [PMID: 39565133 PMCID: PMC11705886 DOI: 10.1128/spectrum.01568-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 10/26/2024] [Indexed: 11/21/2024] Open
Abstract
Neutralizing antibody titers and binding antibody levels are considered correlates of protection against severe SARS-CoV-2 infection. The clinical utility of serology should be reevaluated in light of the emergence of escape variants, as commercial antibody-binding assays have not been adapted to the virus' antigenic evolution. We compared anti-SARS-CoV-2 antibody titers in four quantitative serological tests based on variable ancestral spike antigens (three in-house ELISAs and the prototype VIDAS SARS-CoV-2 IgG QUANT assay) and neutralization assays against the pseudotyped Wuhan, BA.2, BA.4/5, BQ.1.1, and XBB.1.1 viruses in a cohort of 100 patients infected in 2020 or during the Omicron waves. Binding antibody levels correlated well with neutralizing antibody titers for Wuhan, BA.2, and BA.4/5, but the association decreased for BQ.1.1 and XBB.1 (for the VIDAS assay, Spearman's correlation was 0.82 [95% CI 0.74-0.88] and 0.61 [0.46-0.72] for BA.2 and XBB.1, respectively). In 15% of patients with no neutralizing antibodies against XBB.1, the VIDAS assay still yielded binding antibody levels ranging from 74 to 7,652 binding antibody units/mL. Using an adjusted threshold based on receiver operating characteristic (ROC) curve analysis, the specificity of neutralizing antibody detection increased from 0.15 (95% CI 0.02-0.45) and 0.17 (0.04-0.41) to 0.92 (0.64-1.00) and 0.83 (0.59-0.96) against BQ.1.1 and XBB.1, respectively. Serological tests based on receptor-binding domain antigens from the ancestral virus fail to predict neutralizing activity against the latest circulating Omicron variants. Adapting serological tests may improve their clinical utility in immunocompromised patients. IMPORTANCE Anti-SARS-CoV-2 serology was developed in 2020 in response to the COVID-19 pandemic to diagnose SARS-CoV-2 infection and monitor an individual's immunity following natural infection or vaccination. Given the relationship between neutralizing antibody titers and protection against severe infection, many studies have evaluated the correlation between serology tests and neutralization assays in the pre-Omicron era. An important potential clinical use of serology, which explores binding antibodies, is estimating an individual's level of protection against new infection, particularly in immunosuppressed individuals and those at risk of severe COVID. However, in the Omicron era, as new viruses evade the immunity induced by previous infections and vaccination, the correlation between binding antibody levels determined by serological assays developed from ancestral antigens and neutralizing antibody titers against new viruses should be re-examined in order to determine whether these assays should be optimized by adapting antigens to the circulating SARS-CoV-2 strains.
Collapse
Affiliation(s)
- Léa Dépéry
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Isabelle Bally
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Axelle Amen
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire d’Immunologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Benjamin Némoz
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Marlyse Buisson
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Laurence Grossi
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Aurélie Truffot
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Raphaële Germi
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Delphine Guilligay
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Mélanie Veloso
- Cellule d’ingénierie des données, Département de Santé Publique, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Antoine Vilotitch
- Cellule d’ingénierie des données, Département de Santé Publique, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Olivier Epaulard
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Service des Maladies Infectieuses, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Patrice Morand
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Winfried Weissenhorn
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
| | - Pascal Poignard
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - Julien Lupo
- Institut de Biologie Structurale (IBS), CEA, CNRS, Université Grenoble Alpes, Grenoble, France
- Laboratoire de Virologie, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| |
Collapse
|
2
|
Gao S, Ren N, Sun T, Nie Q, Liu S, Geng X, Deng Y, Lin Z, Liu Y, Zhou L. Association of selenium profile with neutralizing antibody response to inactivated SARS-CoV-2 vaccination. J Trace Elem Med Biol 2023; 80:127295. [PMID: 37660572 DOI: 10.1016/j.jtemb.2023.127295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Selenium profile has been related with humoral immune response after vaccination, but evidence with regard to inactivated SARS-CoV-2 vaccine is lacking. OBJECTIVE The current study aimed to examine the relationship between selenium profile and neutralizing antibody response to inactivated SARS-CoV-2 vaccine. METHODS Plasma selenium and selenoprotein P concentrations, neutralizing antibody against the wild-type and Omicron variant were measured at baseline and at 14 days, 98 days after the third dose of inactivated SARS-CoV-2 vaccine. RESULTS Neutralizing antibody against the wild-type and Omicron variant increased significantly after the third vaccination dose. Both higher plasma selenium and selenoprotein P were associated with increased neutralizing antibody against the wild-type strain at baseline. Moreover, higher plasma selenoprotein P was associated with increased neutralizing antibody against Omicron variant at baseline. However, nonsignificant association were observed after the third vaccine dose. CONCLUSION Higher selenium profile was associated with neutralizing antibody response before the third dose of inactivated SARS-CoV-2 vaccine, but not after the third dose. Further prospective cohort studies are warranted to confirm our findings.
Collapse
Affiliation(s)
- Sikang Gao
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Na Ren
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
| | - Taoping Sun
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
| | - Qi Nie
- Department of Nutrition, Hygiene and Toxicology, Academy of Nutrition and Health, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Sitian Liu
- Department of Nutrition, Hygiene and Toxicology, Academy of Nutrition and Health, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xuyang Geng
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
| | - Yao Deng
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
| | - Zefang Lin
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China
| | - Yu Liu
- Zhuhai Precision Medical Center, Guangdong Provincial Key Laboratory of Tumor Interventional Diagnosis and Treatment, Zhuhai People's Hospital, Zhuhai Hospital Affiliated with Jinan University, Jinan University, Zhuhai, China.
| | - Li Zhou
- Department of Nutrition, Hygiene and Toxicology, Academy of Nutrition and Health, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China.
| |
Collapse
|
3
|
Simon G, Favresse J, Gillot C, Closset M, Catry É, Dogné JM, Douxfils J, Wieërs G, Bayart JL. Kinetics and ability of binding antibody and surrogate virus neutralization tests to predict neutralizing antibodies against the SARS-CoV-2 Omicron variant following BNT162b2 booster administration. Clin Chem Lab Med 2023; 61:1875-1885. [PMID: 37078220 DOI: 10.1515/cclm-2022-1258] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/27/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES To assess the long-term humoral immunity induced by booster administration, as well as the ability of binding antibody and surrogate virus neutralization tests (sVNT) to predict neutralizing antibodies (NAbs) against the SARS-CoV-2 Omicron variant. METHODS A total of 269 sera samples were analyzed from 64 healthcare workers who had received a homologous booster dose of BNT162b2. Neutralizing antibodies assessed by sVNT and anti-RBD IgG measured with the sCOVG assay (Siemens Healthineers®) were analyzed at five timepoints; before and up to 6 months following the booster. Antibody titers were correlated with neutralizing antibodies against the Omicron BA.1 variant obtained by pseudovirus neutralization test (pVNT) as a reference method. RESULTS While Wild-type sVNT percentage of inhibition (POI) remained above 98.6% throughout the follow-up period after booster administration, anti-RBD IgG and NAbs assessed by Omicron BA.1 pVNT showed respectively a 3.4-fold and 13.3-fold decrease after 6 months compared to the peak reached at day 14. NAbs assessed by Omicron sVNT followed a steady decline until reaching a POI of 53.4%. Anti-RBD IgG and Omicron sVNT assays were strongly correlated (r=0.90) and performed similarly to predict the presence of neutralizing antibodies with Omicron pVNT (area under the ROC: 0.82 for both assays). In addition, new adapted cut-off values of anti-RBD IgG (>1,276 BAU/mL) and Omicron sVNT (POI>46.6%) were found to be better predictors of neutralizing activity. CONCLUSIONS This study showed a significant drop in humoral immunity 6 months after booster administration. Anti-RBD IgG and Omicron sVNT assays were highly correlated and could predict neutralizing activity with moderate performance.
Collapse
Affiliation(s)
- Germain Simon
- Department of Laboratory Medicine, Clinique St-Pierre, Ottignies, Belgium
| | - Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
- Department of Pharmacy, Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
| | - Constant Gillot
- Department of Pharmacy, Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
| | | | | | - Jean-Michel Dogné
- Department of Pharmacy, Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
- QUALIblood SA, Namur, Belgium
| | - Grégoire Wieërs
- Department of Pharmacy, Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium
- Department of Internal Medicine, Clinique St-Pierre, Ottignies, Belgium
| | - Jean-Louis Bayart
- Department of Laboratory Medicine, Clinique St-Pierre, Ottignies, Belgium
| |
Collapse
|
4
|
Dimeglio C, Da-Silva I, Porcheron M, Panero MP, Staes L, Trémeaux P, Villars H, Izopet J. Weaker Effects of the Fourth Dose of BNT162b2 SARS-CoV-2 Vaccine on the Elderly Human Population. Vaccines (Basel) 2023; 11:1095. [PMID: 37376484 DOI: 10.3390/vaccines11061095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
The vaccines presently available are less effective in older people due to senescence of their immune systems. We measured the antibody responses of 42 adults living in nursing homes after the third and the fourth doses of an mRNA vaccine and found that the strain (BA.2 and BA.2.75: from 64 to 128, BA.5: from 16 to 32, BQ.1.1: from 16 to 64 among the uninfected) influenced the effect of the fourth dose of vaccine on neutralizing antibodies. The fourth dose also increased binding antibodies (from 1036 BAU/mL to 5371 BAU/mL among the uninfected, from 3700 BAU/mL to 6773 BAU/mL among the BA.5 infected). This effect was less significant than that of the third dose of vaccine for both neutralizing (BA.2: from 8 to 128, BA.5: from 2 to 16, BA.2.75: from 8 to 64, BQ.1.1: from 2 to 16) and binding antibodies (from 139.8 BAU/mL to 2293 BAU/mL). However, the fourth dose attained the 5000 BAU/mL threshold conferring approximately 80% protection against a SARS-CoV-2 BA.2 infection in most individuals, unlike the third.
Collapse
Affiliation(s)
- Chloé Dimeglio
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
- Inserm UMR 1291-CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| | - Isabelle Da-Silva
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
| | - Marion Porcheron
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
| | | | - Laetitia Staes
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
| | - Pauline Trémeaux
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
- Inserm UMR 1291-CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| | - Hélène Villars
- Inserm UMR 1295: Center for Research in Population Health (CERPOP), Department of Epidemiology and Public Health, Toulouse, University of Toulouse III, 31073 Toulouse, France
- Geriatric Department, CHU Toulouse, Toulouse University Hospital, Hôpital Purpan Pavillon Leriche, 31300 Toulouse, France
| | - Jacques Izopet
- Virology Laboratory, CHU Toulouse, Hôpital Purpan, 31300 Toulouse, France
- Inserm UMR 1291-CNRS UMR 5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| |
Collapse
|
5
|
Pozo-Balado MDM, Bulnes-Ramos Á, Garrido-Rodríguez V, Olivas-Martínez I, Lozano C, González-Escribano MF, Leal M, Pacheco YM. Longitudinal age differences in humoral responses to the COVID-19 vaccine in the elderly are lost after the third dose. J Infect 2022; 86:154-225. [PMID: 36503017 PMCID: PMC9729577 DOI: 10.1016/j.jinf.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Affiliation(s)
- María del Mar Pozo-Balado
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain
| | - Ángel Bulnes-Ramos
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain
| | - Vanesa Garrido-Rodríguez
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain
| | - Israel Olivas-Martínez
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain
| | - Carmen Lozano
- Microbiology Service, Virgen del Rocío University Hospital (HUVR), Seville, Spain
| | - María Francisca González-Escribano
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain,Immunology Service, Virgen del Rocío University Hospital (HUVR), Seville, Spain
| | - Manuel Leal
- Immunovirology Unit, Internal Medicine Service, Viamed Hospital, Santa Ángela de la Cruz, Seville, Spain,Hogar Residencia de la Santa Caridad, Seville, Spain
| | - Yolanda M Pacheco
- Clinic Unit of Clinic Laboratories, Immunology Laboratory, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital (HUVR)/CSIC/University of Seville, Ave. Manuel Siurot s/n, 41013, Seville, Spain.
| |
Collapse
|
6
|
Dimeglio C, Migueres M, Bouzid N, Chapuy-Regaud S, Gernigon C, Da-Silva I, Porcheron M, Martin-Blondel G, Herin F, Izopet J. Antibody Titers and Protection against Omicron (BA.1 and BA.2) SARS-CoV-2 Infection. Vaccines (Basel) 2022; 10:1548. [PMID: 36146626 PMCID: PMC9506424 DOI: 10.3390/vaccines10091548] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/21/2022] Open
Abstract
The emergence of the SARS-CoV-2 variants of concern has greatly influenced the immune correlates of protection, and there are little data about the antibody threshold concentrations to protect against infection with SARS-CoV-2 Omicron BA.1 or BA.2. We analyzed the antibody responses of 259 vaccinated healthcare workers, some of whom had been previously infected by SARS-CoV-2. The median follow-up was 179 days (IQR: 171-182) after blood collection. We detected 88 SARS-CoV-2 Omicron infections during the follow-up period, 55 (62.5%) with SARS-CoV-2 BA.1, and 33 (37.5%) with SARS-CoV-2 BA.2. A neutralizing antibody titer below 8 provided no protection against a BA.1 infection, a titer of 16 or 32 gave 73.2% protection, and a titer of 64 or 128 provided 78.4% protection. Conversely, the BA.2 infection rate did not vary as a function of anti-BA.2 neutralizing antibody titers. Binding antibody concentrations below 6000 BAU/mL provided no protection against Omicron BA.1 infection, 6000-20,000 BAU/mL provided 55.6% protection, and 20,000 or more provided 87.7% protection. There was no difference in BA.2 infection depending on the binding antibody concentration. Further studies are needed to investigate the relationship between antibody concentrations and infection with the Omicron BA.4/5 variants that are becoming predominant worldwide.
Collapse
Affiliation(s)
- Chloé Dimeglio
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| | - Marion Migueres
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| | - Naémie Bouzid
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
| | - Sabine Chapuy-Regaud
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| | - Caroline Gernigon
- Occupational Diseases Department, Toulouse University Hospital, 31000 Toulouse, France
- UMR1295, Unité Mixte INSERM—Université Toulouse III Paul Sabatier, Centre for Epidemiology and Research in Population Health Unit (CERPOP), 31000 Toulouse, France
| | - Isabelle Da-Silva
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
| | - Marion Porcheron
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
| | - Guillaume Martin-Blondel
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
- Infectious and Tropical Diseases Department, Toulouse University Hospital, 31300 Toulouse, France
| | - Fabrice Herin
- Occupational Diseases Department, Toulouse University Hospital, 31000 Toulouse, France
- UMR1295, Unité Mixte INSERM—Université Toulouse III Paul Sabatier, Centre for Epidemiology and Research in Population Health Unit (CERPOP), 31000 Toulouse, France
| | - Jacques Izopet
- CHU Toulouse, Hôpital Purpan, Virology Laboratory, 31300 Toulouse, France
- Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), 31300 Toulouse, France
| |
Collapse
|