title: Association of serum antibodies with protection against rotavirus infection and disease in South Indian children.
abstract: Serum antibodies play an important role in natural protection from rotavirus infection and disease, but conflicting estimates of association have emerged from epidemiological studies in different geographical settings. In this study, we aim to assess the relationship between pre-existing serum immunoglobulin (Ig)G and IgA titers with protection against rotavirus infection and disease in a birth cohort of Indian children. Children were recruited at birth and followed up for 36 months. Stool samples were collected every 2 weeks and during episodes of diarrhea and serum samples were obtained at least every 6 months. The incidence rate of rotavirus infection and diarrhea was 0.9 (95% CI: 0.88, 0.99) and 0.2 (95% CI: 0.19, 0.25) episodes per child year, respectively. The risk of rotavirus infection and diarrhea decreased with age, while antibody titers (IgG and IgA) increased with age. After adjusting for age and number of previous infections, higher levels of IgG and IgA were independently associated with reduced risk of rotavirus infection. However, we did not find a clear association of IgG or IgA with rotavirus diarrhea risk or a threshold level of protection. The study supports a correlation of serum antibodies in reducing the risk of rotavirus infections, however the potential of serum antibody titer as a correlate of protection is not clear for children in lower income settings.
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-G04, Atlanta, GA 30333, USA; The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Prasanna
authors.initials: P
authors.lastname: Premkumar
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-G04, Atlanta, GA 30333, USA. Electronic address: blopman@cdc.gov.
authors.forename: Ben
authors.initials: B
authors.lastname: Lopman
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Sasirekha
authors.initials: S
authors.lastname: Ramani
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Anu
authors.initials: A
authors.lastname: Paul
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Beryl
authors.initials: B
authors.lastname: Gladstone
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Muliyil
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Indrani
authors.initials: I
authors.lastname: Mukhopadhya
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, MS-G04, Atlanta, GA 30333, USA.
authors.forename: Umesh
authors.initials: U
authors.lastname: Parashar
authors.affiliation: The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu 632004, India.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D002675:Child, Preschool; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D012307:Risk Factors; D012401:Rotavirus; D012400:Rotavirus Infections / Q000453:epidemiology / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G
keywords: Antibody; Diarrhea; Immunity; Protection; Rotavirus
references.citation: J Infect Dis. 1992 Jan;165(1):161-5
references.pmid: 1309372
references.citation: Vaccine. 2012 Apr 27;30 Suppl 1:A3-6
references.pmid: 22520133
references.citation: Hum Vaccin. 2010 Jul;6(7):532-42
references.pmid: 20622508
references.citation: J Med Virol. 1987 Jan;21(1):39-47
references.pmid: 3025356
references.citation: Clin Diagn Lab Immunol. 2005 Feb;12(2):273-9
references.pmid: 15699422
references.citation: Clin Microbiol Infect. 2012 Oct;18 Suppl 5:57-63
references.pmid: 22882248
references.citation: Clin Infect Dis. 2002 May 15;34(10):1351-61
references.pmid: 11981731
references.citation: J Infect Dis. 2013 Jul 15;208(2):284-94
references.pmid: 23596320
references.citation: J Infect Dis. 2002 Sep 1;186(5):593-7
references.pmid: 12195345
references.citation: J Med Virol. 2004 Mar;72(3):416-23
references.pmid: 14748065
references.citation: J Infect Dis. 2000 Oct;182(4):1039-43
references.pmid: 10979897
references.citation: N Engl J Med. 1996 Oct 3;335(14):1022-8
references.pmid: 8793926
references.citation: J Infect Dis. 2009 Nov 1;200 Suppl 1:S39-48
references.pmid: 19817613
references.citation: Arch Dis Child. 2008 Jun;93(6):479-84
references.pmid: 17916587
references.citation: Pediatr Infect Dis J. 1994 Oct;13(10):890-5
references.pmid: 7854889
references.citation: Vaccine. 1995 Sep;13(13):1226-32
references.pmid: 8578808
references.citation: N Engl J Med. 2011 Jul 28;365(4):337-46
references.pmid: 21793745
references.citation: Immunol Rev. 2011 Jan;239(1):125-48
references.pmid: 21198669
references.citation: J Infect Dis. 2000 Dec;182(6):1602-9
references.pmid: 11069230
references.citation: Clin Microbiol Rev. 2008 Jan;21(1):198-208
references.pmid: 18202442