otavirus is the predominant cause of severe
diarrhea in children in both, developed and developing countries [1].
The discovery that cell attachment protein VP8 of human rotavirus
specifically interacts with A-type Histo-Blood Group Antigens (HBGA)
[2,3] have prompted rotavirus epidemiologic studies in relation to host
HBGA phenotypes [4]. A recent study has indicated that the binding
pattern of rotavirus to different HBGAs is strain- dependent [5]
necessitating epidemiological studies in different populations. We aimed
to study the association of rotavirus infection with HBGA phenotype.
This study was conducted between October 2013 to July
2014, and enrolled under-five children admitted with diarrhea to Capital
Hospital Bhubaneswar, Odisha. Approval was obtained from human ethical
committee of RMRC, Bhubaneswar. Children admitted to the hospital with
three or more watery stools within 24 hrs (WHO definition) were enrolled
into the study. Fecal samples (n=389) and finger prick blood (n=147)
were collected from the enrolled children whose parents/guardians
provided consent. Stool samples were tested for rotavirus antigen using
Ridascreen kit [6] and blood group was determined using Monoclonal
ERYSCREEN Tulip Diagnostics Ltd. (India) kit [7].
The enrolled children (n=389;275 males)
belonged to 14 districts of the State. Rotavirus antigen was detected in
54%, of whom majority (52.4%) were between 7-12 months age. Majority
were from low socioeconomic class (class IV-51.6%, class III-45.2%).
Distribution of blood groups among the
gastroenteritis cases is given in Table I. There was no
susceptibility of any particular blood group to rotavirus infection.
However, O blood group seemed to be protective (P=0.02).
TABLE I Distribution of Blood Groups Among Hospitalized Children with Diarrhea
Blood
|
Rotavirus- |
Rotavirus |
Total
|
group |
positive |
negative |
(n=147) |
|
(n=96) |
(n=51)
|
|
A# |
28 (29.2%) |
14 (27.5%) |
42 (28.6%) |
B# |
40 (41.7%) |
13 (25.5%) |
53 (36.1%) |
AB# |
7 (7.3%) |
4 (7.8%) |
11 (7.5%) |
O* |
21(21.9%) |
20 (39. 2%) |
41 (27.9%) |
#P>0.05,*P=0.02.
|
Studies from other parts of the globe revealed varied
results on association of HBGA with rotavirus infection. Trang, et al.
[8] showed all rotavirus-infected children to be HBGA secretors or
partial secretors suggesting that HBGA phenotype is a key susceptibility
factor for rotavirus infection in children. A report from Turkey
suggested an association of rotavirus infection with blood group A [9].
Another study from Turkey; however, did not find any relationship
between rotavirus gastroenteritis and major blood groups [10], a finding
similar to our results.
This study was limited by hospital-based case
enrolment. Given the observations of in vitro studies [4] and
varying results from limited epidemiological studies, large-scale
community-based investigations may add further to the present
literature.
Contributors: EM: conception ofstudy, collection
of data, laboratory investigation and manuscript preparation; BD: study
design, critical review of manuscript; SKK: revision of manuscript and
analysis; RMP: Statistical analysis of data.
Funding: ICMR for Senior Research Fellowship
(EM).
Competing interests: None stated.
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