Prevalence of Groups A and C Rotavirus Antibodies in Infants with Biliary Atresia and Cholestatic Controls
Clemente, M., J. Patton, R. Yolken, P. Whitington, U. Parashar, B. Jiang, Trivellore Raghunathan, and K. Schwarz. 2015. "Prevalence of Groups A and C Rotavirus Antibodies in Infants with Biliary Atresia and Cholestatic Controls." Journal of Pediatrics, 166(1): 79-+.
Objective To analyze the prevalence of acute asymptomatic group A and C rotavirus (RV-A and RV-C) infection in neonates with cholestasis. Study design Participants were infants <180 days of age with cholestasis (serum direct or conjugated bilirubin >20% of total and >= 2 mg/dL) enrolled in the Childhood Liver Disease Research and Education Network during RV season (December-May). Forty infants with biliary atresia (BA), age 62 +/- 29 days (range, 4.7-13 weeks) and 38 infants with cholestasis, age 67 +/- 44 days (range, 3-15.8 weeks) were enrolled. Results At enrollment, RV-A IgM positivity rates did not differ between infants with BA (10%) vs those without (18%) (P = .349). RV-C IgM was positive in 0% of infants with BA vs 3% in those without BA (P = .49). RV-A IgG was lower in infants with BA: 51 +/- 39 vs 56 +/- 44 enzyme-linked immunoassay unit, P = .045 but this difference may lack biological relevance as maternal RV-A IgG titers were similar between groups. Infant RV-A IgM titers at 2-6 months follow-up increased markedly vs at presentation in both infants with BA (50 +/- 30 vs 9 +/- 9) and those without (43 +/- 18 vs 16 +/- 20 enzyme-linked immunoassay unit) (P < .0001), without differences between groups. Conclusions RV-A infection in the first 6 months of life is common in infants with cholestasis of any cause. RV-A could have different pathogenetic effects by initiating different hepatic immune responses in infants with vs without BA or could lack pathogenetic significance.