High frequency of rotavirus viremia in children with acute gastroenteritis: Discordance of strains detected in stool and sera

Abstract

Recently, rotavirus antigenemia and viremia have been identified in patients with acute gastroenteritis. This study examined rotavirus viremia in children hospitalized for acute gastroenteritis in order to establish its association with fecal shedding of rotavirus, infecting genotypes and antibody marker of acute infection. Thirty-one pairs of stool-serum specimens were collected from November 2004 to February 2005 together with clinical information. All paired specimens were screened for rotavirus RNA by RT-PCR using the VP6 gene primers. All stool and serum specimens were tested for rotavirus antigen and anti-rotavirus IgM respectively by ELISA. Sixteen of 31 stool-serum pairs showed the presence of rotavirus RNA. Nine stool and two serum specimens were positive only by RT-PCR. The total positivity in rotavirus RNA was significantly higher in both stools (80.6%) and sera (58.1%) than that of stool antigen (38.7%) and anti-rotavirus IgM (25.8%) (P < 0.01). All PCR positive paired specimens were typed for the VP7 (G) and VP4 (P) genes. Five of sixteen pairs could be typed for both genes. Three of the five pairs showed concordance (G2P[4]/G2P[4]) while two showed discordance (G12P[8]/G2P[4], G8P[4]/G2P[4]) in the genotypes detected in stool and serum specimens respectively. The study documents a high frequency of rotavirus viremia in patients with acute diarrhea. The discordance of rotavirus strains at the genotypic level in the serum and stool of individual patients with diarrhea suggests the susceptibility of extra-intestinal sites for rotavirus infection and the possibility of differential dissemination of rotavirus strains from the intestine.

VP7 and VP4 Sequence Analyses of Rotavirus Strains From Italian Children With Viraemia and Acute Diarrhoea

“…Because this region of VP8 is spatially close to the sugar-binding pocket of human rotaviruses (15), it may be speculated that residue 106 may be involved in rotavirus binding of the cell receptor. (16). In our study, such a great genetic discordance between stool and blood strains was not observed, because when typeable, only limited nucleotide divergences were documented.…”

Rotavirus infection markers in children with rotaviral gastroenteritis and their relation to disease severity

“…Similarly, Ficher et al (2005) 3found that children with primary rotavirus infection, indicated by low titres of rotavirus antibodies in acute phase serum samples, had more antigen detected in their serum than did children with higher acute phase titres, which suggested past infection or the presence of maternal antibodies. Also, in accordance with the same study ofChitambar SD et al (2008) 14 , we noted that serum viremia was detected despite the lower level of antibodies, and the mean IgM level was significantly lower in PCR positive patient as compared to PCR negative patients.…”

Viral infections: new and emerging

“…Of these, three showed gene concordance, whereas two of the five were discordant. This suggests an extraintestinal site of rotavirus infection or differential rotavirus dissemination [10 ]. These findings are similar to those of a recent Italian study [11].…”