Prevalence of Groups A and C Rotavirus Antibodies in Infants with Biliary Atresia and Cholestatic Controls - 25/10/14

Doi : 10.1016/j.jpeds.2014.09.033

Maria Grazia Clemente, MD, PhD ¹, John T. Patton, PhD ², Robert Yolken, MD ³, Peter F. Whitington, MD ⁴, Umesh D. Parashar, MD ⁵, Baoming Jiang, PhD ⁵, Trivellore Raghunathan, PhD ⁶, Kathleen B. Schwarz, MD ^1,^⁎
¹ Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD
² Laboratory of Infectious Diseases, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
³ Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD
⁴ Department of Pediatrics, Feinberg School of Medicine of Northwestern University, Chicago, IL
⁵ Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA
⁶ Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI

^∗Reprint requests: Kathleen B. Schwarz, MD, Department of Pediatrics, Johns Hopkins Medical Institutions, CMSC 2-125, 600 North Wolfe St, Baltimore, MD 21287.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 25 October 2014

Abstract

Objective

To analyze the prevalence of acute asymptomatic group A and C rotavirus (RV-A and RV-C) infection in neonates with cholestasis.

Study design

Participants were infants <180 days of age with cholestasis (serum direct or conjugated bilirubin >20% of total and ≥2 mg/dL) enrolled in the Childhood Liver Disease Research and Education Network during RV season (December-May). Forty infants with biliary atresia (BA), age 62 ± 29 days (range, 4.7-13 weeks) and 38 infants with cholestasis, age 67 ± 44 days (range, 3-15.8 weeks) were enrolled.

Results

At enrollment, RV-A IgM positivity rates did not differ between infants with BA (10%) vs those without (18%) (P = .349). RV-C IgM was positive in 0% of infants with BA vs 3% in those without BA (P = .49). RV-A IgG was lower in infants with BA: 51 ± 39 vs 56 ± 44 enzyme-linked immunoassay unit, P = .045 but this difference may lack biological relevance as maternal RV-A IgG titers were similar between groups. Infant RV-A IgM titers at 2-6 months follow-up increased markedly vs at presentation in both infants with BA (50 ± 30 vs 9 ± 9) and those without (43 ± 18 vs 16 ± 20 enzyme-linked immunoassay unit) (P < .0001), without differences between groups.

Conclusions

RV-A infection in the first 6 months of life is common in infants with cholestasis of any cause. RV-A could have different pathogenetic effects by initiating different hepatic immune responses in infants with vs without BA or could lack pathogenetic significance.

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Keyword : BA, BARC, EIU, ELISA, OD, RV, RRV, RV-A, RV-C, VLP, VP

Plan

Supported by the National Institute of Diabetes and Digestive and Kidney Diseases (U54DK078377, DK 62530 [Johns Hopkins]), and National Center for Research Resources, National Institutes of Health (NIH; 5M01 RR00069 [University of Colorado], UL1RR025005 [Johns Hopkins]) Zachary Meehan Foundation, Sydney Moss Foundation, the Johns Hopkins Pediatric Liver Center Gift Fund. J.P. was supported by the Intramural Research Program of the National Institute of Allergy and Infectious Diseases of NIH. The finding and conclusions in this report are those of the authors and do not necessarily represent the views of CDC. The authors declare no conflicts of interest.