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J Infect Dis. 2017 Aug 1;216(3):317-326. doi: 10.1093/infdis/jix310.

Naturally Acquired Immunity Against Rotavirus Infection and Gastroenteritis in Children: Paired Reanalyses of Birth Cohort Studies.

Author information

1
Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
2
Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut.
3
Department of Epidemiology, Rollins School of Public Health, Emory University.
4
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
5
Institute of Infection and Global Health, University of Liverpool, United Kingdom.
6
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre.
7
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
8
Instituto Nacional de Ciences Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Abstract

Background:

Observational studies in socioeconomically distinct populations have yielded conflicting conclusions about the strength of naturally acquired immunity against rotavirus gastroenteritis (RVGE), mirroring vaccine underperformance in low-income countries. We revisited birth cohort studies to understand naturally acquired protection against rotavirus infection and RVGE.

Methods:

We reanalyzed data from 200 Mexican and 373 Indian children followed from birth to 2 and 3 years of age, respectively. We reassessed protection against RVGE, decomposing the incidence rate into the rate of rotavirus infection and the risk of RVGE given infection, and tested for serum antibody correlates of protection using regression models.

Results:

Risk for primary, secondary, and subsequent infections to cause RVGE decreased per log-month of age by 28% (95% confidence interval [CI], 12%-41%), 69% (95% CI, 30%-86%), and 64% (95% CI, -186% to 95%), respectively, in Mexico City, and by 10% (95% CI, -1% to 19%), 51% (95% CI, 41%-59%) and 67% (95% CI, 57%-75%), respectively, in Vellore. Elevated serum immunoglobulin A and immunoglobulin G titers were associated with partial protection against rotavirus infection. Associations between older age and reduced risk for RVGE or moderate-to-severe RVGE given infection persisted after controlling for antibody levels.

Conclusions:

Dissimilar estimates of protection against RVGE may be due in part to age-related, antibody-independent risk for rotavirus infections to cause RVGE.

KEYWORDS:

birth cohort; gastroenteritis; immunity; natural infection; rotavirus

PMID:
28859432
PMCID:
PMC5853322
DOI:
10.1093/infdis/jix310
[Indexed for MEDLINE]
Free PMC Article

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