title: Evaluating the Impact of Breastfeeding on Rotavirus Antigenemia and Disease Severity in Indian Children.
abstract: OBJECTIVE
  To evaluate the contribution of breastfeeding to Rotavirus (RV)-induced antigenemia and/or RNAemia and disease severity in Indian children (<2 yrs age).
  
  
  METHODS
  Paired stool and serum samples were collected from (a) hospitalized infants with diarrhea (n = 145) and (b) healthy control infants without diarrhea (n = 28). Stool RV-antigen was screened in both groups by commercial rapid-test and enzyme immunoassay. The disease severity was scored and real-time-PCR was used for viral-load estimation. Serum was evaluated for RV-antigenemia by EIA and RV-RNAemia by RT-PCR. Data was stratified by age-group and breastfeeding status and compared.
  
  
  RESULTS
  Presence of RV-antigenemia and RV-RNAemia was positively related with presence of RV in stool. Disease severity and stool viral-load was significantly associated with RV-antigenemia [(r = 0.74; CI:0.66 to 0.84; P<0.0001,R2 = 0.59) and (r = -0.55; CI:-0.68 to -0.39; P<0.0001,R2 = 0.31) respectively], but not with RV-RNAemia. There was significant reduction in RV-antigenemiarate in the breast-fed group compared to non-breastfed infants, especially in 0-6 month age group (P<0.001). Non-breastfed infants were at risk for RV-antigenemia with severe disease manifestations in form of high Vesikari scores correlating with high fever, more vomiting episodes and dehydration.
  
  
  CONCLUSIONS
  RV-antigenemia was common in nonbreastfed children with severe RV-diarrhea and correlated with stool RV-load and disease severity.
authors.affiliation: Department of Microbiology, All-India Institute of Medical Sciences (AIIMS), Patna, India.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Das
authors.affiliation: Virology Unit, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India.
authors.forename: Ganesh Chandra
authors.initials: GC
authors.lastname: Sahoo
authors.affiliation: Virology Unit, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Das
authors.affiliation: Department of Paediatrics, Nalanda Medical College and Hospital, Patna, India.
authors.forename: Utpal Kant
authors.initials: UK
authors.lastname: Singh
authors.affiliation: Department of Paediatrics, Nalanda Medical College and Hospital, Patna, India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Jaiswal
authors.affiliation: Department of Paediatrics, Nalanda Medical College and Hospital, Patna, India.
authors.forename: Prachi
authors.initials: P
authors.lastname: Singh
authors.affiliation: Virology Unit, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India.
authors.forename: Ranjeet
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Virology Unit, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, India.
authors.forename: Rishikesh
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000956:Antigens, Viral / Q000097:blood*; D001942:Breast Feeding; D002648:Child; D005260:Female; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D012367:RNA, Viral / Q000097:blood; D012401:Rotavirus / Q000276:immunology*; D012720:Severity of Illness Index; D019562:Viral Load; D014766:Viremia / Q000097:blood* / Q000453:epidemiology*
chemical_list: D000956:Antigens, Viral; D012367:RNA, Viral
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