Extraintestinal rotavirus infections in children with immunodeficiency

• Published in: The Journal of pediatrics Vol. 120; no. 6; pp. 912 - 917
• Main Authors: Gilger, M.A., Matson, D.O., Conner, M.E., Rosenblatt, H.M., Finegold, M.J., Estes, M.K.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.06.1992; Elsevier
• Subjects: Acquired Immunodeficiency Syndrome - complications; AIDS/HIV; Biological and medical sciences; Diarrhea, Infantile - microbiology; DiGeorge Syndrome - complications; Female; Hepatitis, Viral, Human - microbiology; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunoenzyme Techniques; Immunopathology; Infant; Kidney Diseases - microbiology; Male; Medical sciences; Rotavirus - isolation & purification; Rotavirus - physiology; Rotavirus Infections - complications; Severe Combined Immunodeficiency - complications; Virus Replication; Human; Immunopathology; Liver; AIDS; Reoviridae; Kidney; Infection; Virus; Concomitant disease; Microbiological investigation; Viral disease; Duovirus; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(05)81959-6

Some rotavirus strains, including vaccine candidates, have been demonstrated to cause hepatitis in immunodeficient and malnourished mice and to grow in human liver cells. To determine whether rotavirus spreads outside the intestine in naturally infected children, we examined tissues from four immunodeficient children affected with severe combined immunodeficiency disease, acquired immunodeficiency disease syndrome, or DiGeorge syndrome. Chronic rotavirus-related diarrhea, which persisted until death, had also developed in each child. Using indirect immunoperoxidase techniques, we identified rotavirus antigen in the liver and kidney with a hyperimmune guine pig antiserum prepared to double-shelled rotavirus particles. Similar immunostaining with an antiserum to a rotavirus nonstructural protein (NS26) provided evidence of active virus replication. The observed reactivity was eliminated specifically when serial sections were immunostained with the same antiserum that had been absorbed with either double-shelled rotavirus particles or NS26. Immunostaining was not observed in the liver of children with other diseases ( α 1-antitrypsin deficiency, inspissated bile syndrome, and acute rejection of a transplanted liver). These findings demonstrate that rotavirus infections in children can extend beyond the intestinal tract. Further studies are warranted to determine whether extraintestinal rotavirus replication occurs in children without severe immunodeficiency, such as malnourished children.