Association between Norovirus and Rotavirus Infection and Histo-Blood Group Antigen Types in Vietnamese Children

Norovirus and rotavirus are the two most important causes of acute gastroenteritis in children worldwide. Both norovirus and rotavirus recognize human histo-blood group antigens (HBGAs), and multiple binding patterns for HBGAs have been reported. To explore the role of HBGAs in host susceptibility to norovirus and rotavirus, we conducted a cross-sectional study in children hospitalized with diarrhea in northern Vietnam from September 2010 through September 2012. Of 260 children with paired stool and saliva samples, 158 (61%) were classified as HBGA secretors (Le(a+b-)), 31 (12%) were nonsecretors (Lea(-b+)), and 71 (27%) were partial secretors (Le(a+b-)). Norovirus was detected in 50 patients (19%), with viral genotypes GII. 3 (n= 28) and GII. 4 (n = 22) being the most common. All children infected with norovirus strains of genotype GII. 4 were either HBGA secretors or partial secretors. Of the 28 GII. 3 cases, 12 involved HBGA secretors, 11 partial secretors, and 5 nonsecretors. A total of 85 children tested positive for rotavirus, 74 of whom were infected with genotype P[8], 5 with P[4], and 6 with P[6]; all were HBGA secretors or partial secretors. This is the first epidemiological study demonstrating in a population that HBGA phenotype is a key susceptibility factor for both norovirus and rotavirus infections in children.