ArticlemedRxiv : the preprint server for health sciences2026
Multiple, but not isolated, yellow fever virus-associated orthoflavivirus immune histories drive antibody-dependent enhancement of Zika and dengue viruses.
Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Antibody-dependent enhancement (ADE) is a major concern across orthoflavivirus infections, yet how multiple viral exposures shape enhancement risk remains incompletely understood. Here, we integrated serosurveillance from Saúde, Brazil with functional immunologic analyses to define how yellow fever virus (YFV)-associated orthoflavivirus immune histories influence ADE phenotypes. Using serocomplex-specific anti-premembrane antibody profiling validated by microneutralization assays, plasma samples were stratified into YFV-only, YFV+DENV, and YFV+DENV+ZIKV exposure groups. In Fcγ receptor-bearing U937 cells, YFV-only plasma demonstrated minimal enhancement activity, whereas cumulative orthoflavivirus exposure generated broader ADE phenotypes across heterologous viruses. In
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