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      Virological and Immunological Outcomes of Coinfections

      , , , ,
      Clinical Microbiology Reviews
      American Society for Microbiology

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          SUMMARY

          Coinfections involving viruses are being recognized to influence the disease pattern that occurs relative to that with single infection. Classically, we usually think of a clinical syndrome as the consequence of infection by a single virus that is isolated from clinical specimens. However, this biased laboratory approach omits detection of additional agents that could be contributing to the clinical outcome, including novel agents not usually considered pathogens. The presence of an additional agent may also interfere with the targeted isolation of a known virus. Viral interference, a phenomenon where one virus competitively suppresses replication of other coinfecting viruses, is the most common outcome of viral coinfections. In addition, coinfections can modulate virus virulence and cell death, thereby altering disease severity and epidemiology. Immunity to primary virus infection can also modulate immune responses to subsequent secondary infections. In this review, various virological mechanisms that determine viral persistence/exclusion during coinfections are discussed, and insights into the isolation/detection of multiple viruses are provided. We also discuss features of heterologous infections that impact the pattern of immune responsiveness that develops.

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          Author and article information

          Journal
          Clinical Microbiology Reviews
          Clin Microbiol Reviews
          American Society for Microbiology
          0893-8512
          1098-6618
          October 2018
          July 05 2018
          : 31
          : 4
          Article
          10.1128/CMR.00111-17
          6148187
          29976554
          2289d811-61a6-4c10-bff0-eacc8fd32cd3
          © 2018
          History

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