Early-life rotavirus and norovirus infections in relation to development of atopic manifestation in infants.
BACKGROUND
The increase in incidence of atopic diseases (ADs) in the developed world over the past decades has been associated with reduced exposure of childhood infections.


OBJECTIVE
To investigate the relation between early intestinal viral infections in relation to the development of atopic symptoms (eczema, wheeze and atopic sensitization) in the first and second year(s) of life.


METHODS
In the KOALA Birth Cohort Study, we assessed IgG seropositivity for rota- and norovirus (GGI.1 and GGII.4) at 1 year of age. This was related to allergic sensitization [specific immunoglobulin E (IgE)] at 1 and 2 years, and parent reported eczema and wheeze in the first 2 years, using logistic regression analysis adjusted for confounders.


RESULTS
Rotavirus seropositivity (39%) was associated with an unexpected higher risk of recurrent wheeze in the first and second year of life [adjusted odds ratio (OR) 3.1 and 95% confidence intervals (CI) 1.1-9.1] and persistent and new recurrent wheeze (adjusted OR 2.7 and 95% CI 1.1-6.2). No further associations were found between intestinal viral seropositivity and atopic manifestations.


CONCLUSIONS
Our data did not show a clear protection by enteric viral infections in young children on development of IgE response to allergens, but rotavirus infection in the first year was a risk factor for wheeze. However, this needs to be followed up to older ages in order to establish the true importance of intestinal viral infections and especially cumulative effects in AD aetiology. Exposure to rotavirus may offer a new and interesting focus on infant wheeze and later asthma development.
Reimerink
J
J
Laboratory for Infectious Diseases and Screening, National Institute of Public Health and the Environment (RIVM), Bilthoven, Maastricht, Amsterdam, The Netherlands. johan.reimerink@rivm.nl
Stelma
F
F
Rockx
B
B
Brouwer
D
D
Stobberingh
E
E
van Ree
R
R
Dompeling
E
E
Mommers
M
M
Thijs
C
C
Koopmans
M
M
D000485:Allergens / Q000276:immunology; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000276:immunology; D017250:Caliciviridae Infections / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000821:virology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D029322:Norovirus / Q000276:immunology; D016017:Odds Ratio; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors; D012400:Rotavirus Infections / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D016036:Seroepidemiologic Studies
D000485:Allergens; D000914:Antibodies, Viral; D000956:Antigens, Viral; D007073:Immunoglobulin E