title: Rotavirus antigenemia in children is associated with more severe clinical manifestations of acute gastroenteritis.
abstract: BACKGROUND
  Rotavirus (RV) antigenemia and RNAemia are common findings in rotavirus-infected children. Sporadic associations between RV antigenemia and extraintestinal manifestations of RV infection have been observed. We examined the clinical severity of RV gastroenteritis in patients with and without RV antigenemia or RNAemia.
  
  
  METHODS
  Stool, serum and whole blood samples were collected from children seen with acute gastroenteritis in Tampere University Hospital and studied for RV using reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay. Only exclusively RV-positive specimens were included into this study. The patients were divided into groups according to RV findings from stool, serum and blood specimens. Clinical manifestations were graded according to 20-point Vesikari scoring system.
  
  
  RESULTS
  Of 374 children, 155 (41%) had RV in their stools. Of these 155 children, 105 (67%) were found to have RV RNA in the serum; of those, 94 (90%) had also RV enzyme-linked immunosorbent assay antigen. Thus antigenemia occurred in 61% (94 cases) of RV-infected children all of whom had concomitant RNAemia. Neither antigenemia nor RNAemia were detected in 85 patients with non-RV gastroenteritis. Patients who had RV RNA and RV antigen in both serum and stools were more likely to have a higher level of fever and more severe vomiting than patients who had RV only in stools. G1 genogroup RV was more often associated with RNAemia and antigenemia than other genogroups combined.
  
  
  CONCLUSIONS
  Rotavirus antigenemia and viremia are commonly detected in children hospitalized for RV gastroenteritis and may be associated with increased severity of fever and vomiting.
authors.affiliation: From the *Vaccine Research Center, University of Tampere; and †Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Hemming
authors.forename: Leena
authors.initials: L
authors.lastname: Huhti
authors.forename: Sirpa
authors.initials: S
authors.lastname: Räsänen
authors.forename: Marjo
authors.initials: M
authors.lastname: Salminen
authors.forename: Timo
authors.initials: T
authors.lastname: Vesikari
mesh_terms: D000956:Antigens, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000821:virology; D005759:Gastroenteritis / Q000097:blood / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis / Q000097:blood; D012401:Rotavirus / Q000276:immunology / Q000302:isolation & purification*; D012400:Rotavirus Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D014766:Viremia / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology
chemical_list: D000956:Antigens, Viral; D012367:RNA, Viral