A systematic review of dengue controlled human infection studies: safety, viral kinetics and immunology - PubMed
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- #dengue
- #vaccine development
- #human infection studies
- Systematic review of dengue controlled human infection studies (DCHIM) focusing on safety, viral kinetics, and immunology.
- DCHIMs address gaps in understanding dengue immunopathogenesis, lack of antiviral therapies, and vaccine-related concerns.
- Review protocol registered with PROSPERO (CRD42024558534), covering studies from January 2000 to December 2025.
- 11 published studies identified, involving 248 participants aged 18-55, all conducted in non-endemic areas.
- Primary outcome measured was the proportion of participants developing viraemia ('attack rate').
- Attack rates varied by serotype and participant serostatus: 50-100% in seronegative, 0-83% in vaccinated individuals.
- Clinical and biochemical features of dengue fever varied between strains, with peak viral load correlating with fever probability.
- No serious adverse events reported; 4% of participants met hospitalization criteria.
- Evidence of disease enhancement observed in 7% of challenged seropositive participants.
- DCHIMs are safe and valuable for vaccine development but need expansion to endemic settings and secondary dengue models.