Modeling Dengue Immune Responses Mediated by Antibodies: Insights on the Biological Parameters to Describe Dengue Infections

Dengue fever is a viral mosquito-borne disease, a significant global health concern, with more than one third of the world population at risk of acquiring the disease. Caused by 4 antigenically distinct but related virus serotypes, named DENV-1, DENV-2, DENV-3, and DENV-4, infection by one serotype confers lifelong immunity to that serotype and a short period of temporary cross immunity to other related serotypes. Severe dengue is epidemiologically associated with a secondary infection caused by a heterologous serotype via the so-called antibody-dependent enhancement (ADE), an immunological process enhancing a new infection. Within-host dengue modeling is restricted to a small number of studies so far. With many open questions, the understanding of immunopathogenesis of severe disease during recurrent infections is important to evaluate the impact of newly licensed vaccines. In this paper, we revisit the modeling framework proposed by Sebayang et al. and perform a detailed sensitivity analysis of the well-known biological parameters and its possible combinations to understand the existing data sets. Using numerical simulations, we investigate features of viral replication, antibody production, and infection clearance over time for three possible scenarios: primary infection, secondary infection caused by homologous serotype, and secondary infection caused by heterologous serotype. Besides, describing well the infection dynamics as reported in the immunology literature, our results provide information on parameter combinations to best describe the differences on the immunological dynamics of secondary infections with homologous and heterologous viruses. The results presented here will be used as baseline to investigate a more complex within-host dengue model.