Innate susceptibility to norovirus infections influenced by XXXX genotype in a United States pediatric population.

@entity1 @entity697 @entity10355 @entity11632 @entity4092
BACKGROUND:    Norovirus is a leading cause of @entity697 ( @entity697 ). Noroviruses bind to gut histo-blood group antigens (HBGAs), but only 70-80% of individuals have a functional copy of the @entity11632 ("secretor") gene required for gut @entity10355 expression; these individuals are known as "secretors." Susceptibility to some noroviruses depends on @entity11632 secretor status, but the population impact of this association is not established. METHODS:    From 12/2011 to 11/2012, active @entity697 surveillance was performed at six geographically diverse US pediatric sites. Cases under five years were recruited from emergency departments and inpatient units; age-matched healthy controls were recruited at well- @entity1 visits. Salivary DNA was collected to determine secretor status and genetic ancestry. Stool was tested for norovirus by realtime RT-PCR. Norovirus genotype was then determined by sequencing. RESULTS:    Norovirus was detected in 302 (21%) of 1465 @entity697 cases and 52 (6%) of 826 healthy controls. Norovirus @entity697 cases were 2.8-fold more likely than norovirus-negative controls to be secretors (p<0.001) in a logistic regression model adjusted for ancestry, age, site, and health insurance. Secretors comprised all 155 cases and 21 @entity4092 with the most prevalent norovirus, GII.4. Control @entity1 of Meso-American ancestry were more likely than @entity1 of European or African ancestry to be secretors (96% versus 74%, p<0.001). CONCLUSIONS:    @entity11632 status is associated with norovirus infection and varies by ancestry. GII.4 norovirus exclusively infected secretors. These findings are important to norovirus vaccine trials and design of agents that may block norovirus- @entity10355 binding.
