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Clinical and Diagnostic Laboratory Immunology, February 2005, p. 273-279, Vol. 12, No. 2
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.2.273-279.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Serum Antibody Responses in Children with Rotavirus Diarrhea Can Serve as Proxy for Protection

J. Xu,1,{dagger} P. Dennehy,2 H. Keyserling,3 L. E. Westerman,1 Y. Wang,1 R. C. Holman,1 J. R. Gentsch,1 R. I. Glass,1 and B. Jiang*

Division of Viral and Rickettsial Diseases, Centers for Disease Control and Prevention,1 Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia,3 Division of Pediatric Infectious Diseases, Rhode Island Hospital, Brown University, Providence, Rhode Island2

Received 7 October 2004/ Returned for modification 5 November 2004/ Accepted 29 November 2004

We examined sera from 42 patients 1 to 30 months of age for rotavirus immunoglobulin M (IgM), IgA, IgG, and IgG subclasses and sought to determine if serum antibody could serve as a reliable marker for prediction of disease severity. Infants in the first few months of life usually had high maternal IgG titers and, when they were infected with rotavirus, had low IgM titers or no IgM in acute-phase sera and poor seroconversions 3 weeks later, suggesting that maternal antibodies had inhibited viral replication and antibody responses. All patients ≥6 months of age had IgM in acute-phase sera, indicating that IgM is a good marker for acute rotavirus infection. IgG was the best overall predictor of an infection, as the convalescent-phase sera of 81% of the patients had a fourfold rise in the IgG titer. IgA titers in convalescent-phase sera and conversion rates were higher among patients ≥12 months of age than among children younger than 12 months. IgG1 was the predominant subclass detected in the acute-phase sera of some children and in all 28 convalescent-phase serum samples examined. Patients with preexisting acute-phase IgG titers of ≥100 or ≥200 had diarrhea that was less severe or of a shorter duration. These results indicate that serum IgG is the most reliable marker for seroconversion and is a consistent proxy for protection against severe disease.

* Corresponding author. Mailing address: Respiratory and Enteric Viruses Branch, MS G04, National Center for Infectious Diseases, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-2861. Fax: (404) 639-3645. E-mail: bjiang{at}cdc.gov.

{dagger} Present address: Children's Hospital, Fudan University, Shanghai 200032, People's Republic of China.

Clinical and Diagnostic Laboratory Immunology, February 2005, p. 273-279, Vol. 12, No. 2
1071-412X/05/$08.00+0     doi:10.1128/CDLI.12.2.273-279.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.





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