期刊
CLINICAL INFECTIOUS DISEASES
卷 72, 期 2, 页码 222-229出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa019
关键词
norovirus; homotypic protection; heterotypic protection; GII.4; reinfection
资金
- Bill & Melinda Gates Foundation
- Foundation for the National Institutes of Health (NIH)
- NIH Fogarty International Center
- Fisher Center for Environmental Infectious Diseases at the Johns Hopkins School of Medicine
- Bill & Melinda Gates Foundation [OPP1066146]
- CDC
- Bill and Melinda Gates Foundation [OPP1066146] Funding Source: Bill and Melinda Gates Foundation
Children infected with GII.4 noroviruses demonstrated both homotypic and heterotypic protection to reinfection with other genotypes, supporting the need for ongoing vaccine development efforts with GII.4 as the main component. Prior exposure to GI.3, GII.2, and GII.17 infections enhanced susceptibility to subsequent infections with several other norovirus genotypes.
Background. Norovirus is a leading cause of acute gastroenteritis worldwide, yet there is limited information on homotypic or heterotypic protection following natural infection to guide vaccine development. Methods. A total of 6020 stools collected from 299 Peruvian children between 2010 and 2014 were tested by norovirus real-time reverse-transcription polymerase chain reaction followed by sequence-based genotyping. Cox proportional hazards models were used to derive adjusted hazard ratios (HRs) of infection among children with vs without prior exposure. Results. Norovirus was detected in 1288 (21.3%) samples. GII.4 (26%), GII.6 (19%), and GI.3 (9%) viruses accounted for 54% of infections. Homotypic protection for GI.3 (HR, 0.35; P = .015), GI.7 (HR, 0.19; P = .022), GII.4 (HR, 0.39; P < .001), and GII.6 (HR, 0.52; P = .006) infections was observed. Hazard analysis showed that children with prior GII.4 infection exhibited heterotypic protection with a 48% reduction of subsequent GI.3 infection (HR, 0.52; P = .005). Prior exposure to GI.3, GII.2, and GII.17 infections enhanced susceptibility to subsequent infections with several other norovirus genotypes. Conclusions. Children up to 2 years of age infected with GII.4 noroviruses demonstrated both homotypic and heterotypic protection to reinfection with other genotypes. These data support the need for ongoing vaccine development efforts with GII.4 as the main component and caution the inclusion of genotypes that may enhance susceptibility to infections.
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