Zika Virus: A Review of Biology, Clinical Impacts, and Coinfections

Abstract

The Zika virus (ZIKV) gained prominence as a significant global pathogen after the 2015-2016 outbreaks associated it with an increase in neurological complications in adults and congenital malformations. Different mechanisms have been proposed by which ZIKV may cross the blood-brain barrier and reach the central nervous system to cause neuroinflammation. Although ZIKV infection triggers a robust immune response, the virus has developed different strategies to escape it. Furthermore, although the virus is present in areas with cocirculation of other pathogenic agents, few studies have evaluated the cross-immune reactions and coinfection of ZIKV. Coinfections of ZIKV with other viruses, parasites, and bacteria are described. Such interactions can worsen infections and alter the immune response, imposing new therapeutic challenges and highlighting the need for more studies in the field. In this review, we discuss various aspects of ZIKV biology, focusing on the impacts of coinfections.

Keywords: Congenital Zika Syndrome; coinfections; flavivirus; pathogen interactions.

Figure 1

Genomic composition and viral proteins of the Zika virus. (A) The structure of the virion, and (B) the genome, which contains the sequences that encode the structural and non-structural proteins.

Figure 2

Ways in which humans can be coinfected by arboviruses. (A) A mosquito coinfected with two viruses feeds on an individual. (B) Two mosquitoes infected with different arboviruses feed on the same individual.