A binary classification system has been established for group A rotaviruses, with the viral capsid protein VP7 defining G types and VP4 defining P types. At least 15 G types and 21 P types have been isolated globally with various G and P combinations. Most of the currently circulating human rotaviruses belong to G1P[8], G2P[4], G3P[8], and G4P[8]. We report a human rotavirus strain (B1711) with a novel genotypic VP7/VP4 combination of G6P[6]. This unique rotavirus was isolated from a 13-month-old human immunodeficiency virus (HIV)-negative child of an HIV-seropositive Malian mother that was hospitalized with severe diarrhea in Belgium after returning from a trip to Mali. The VP7 and VP4 genes of the rotavirus strain were sequenced, and phylogenetic trees were constructed. Nucleotide and amino acid sequence comparisons with 15 known G genotypes indicated that the VP7 sequence of strain B1711 was most closely related to an American (Se584) and an Italian (PA151) human G6 strain (95 to 96% nucleotide and 98% amino acid identity). Comparison of the VP4 sequence with 21 P types showed the closest similarity to P[6] genotypes, with greatest similarity to a G8P[6] Malawi strain (mw131) (97% nucleotide and 98% amino acid identity). The B1711 strain is the first reported rotavirus isolate with a G6P[6] genotypic combination. The discovery and surveillance of novel human and nonhuman rotavirus G or P types or of novel G/P combinations is essential for the design of future rotavirus vaccines and for our understanding of rotavirus diversity and evolution.Group A rotaviruses are the single most important etiological agent associated with gastroenteritis in infants and young children (2, 40). Rotavirus-associated diarrhea leads to more than 125 million cases of infantile gastroenteritis and 870,000 deaths each year, primarily in less developed countries (54). In the United States it also results in $274 million in medical care costs and a total of $1 billion in societal costs (including indirect cost of lost parental work time) per year (47). Rotaviruses contain 11 segments of double-stranded RNA within a core shell and are members of the Reoviridae family. Each segment encodes a single viral polypeptide, for a total of five nonstructural and six structural proteins (17). The two outer capsid proteins VP7 and VP4, which independently elicit neutralizing antibodies, are the basis of a binary classification system for rotaviruses: G types (derived from the VP7 glycoprotein) and P types (derived from the protease sensitive VP4 protein). Thus far, 15 different G genotypes and 21 different P genotypes have been reported (2,26,31,48). Because VP4 and VP7 are encoded by different RNA segments, various combinations of G and P types can be observed (40). Most G genotypes were serologically confirmed as serotypes (25). Due to the lack of appropriate antibody reagents, a dual P-typing system (P serotype and P genotype) has been used (18). Strains sharing more than 89% sequence identity at the amino acid level are considered to belong to...

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The aim of this study was to evaluate the diagnostic reliability and prognostic significance of the quantification of cytomegalovirus (CMV) DNA in amniotic fluid (AF). We retrospectively reviewed the results for 282 amniotic fluid samples that had been tested for CMV by a quantitative real-time PCR. We observed three cases in which no CMV genomes were detected in the AF but in which the children were nevertheless congenitally infected. Hence, we conclude that a negative result by PCR for CMV in AF cannot rule out the possibility of congenital infection. No false-positive PCR results were observed. A correlation between the CMV viral load in AF and the fetal and neonatal outcomes could not be demonstrated in our study. Instead, a correlation was found between the CMV viral load and the gestational age at the time of amniocentesis.Human cytomegalovirus (CMV) is the leading cause of congenital viral infection in developed countries, with the reported incidence varying between 0.2 and 2.2% of all live births (15,35). The transmission rate following primary infection of the mother is about 40%. Only 10 to 15% of the CMV-infected children are symptomatic at birth, and the symptoms range from mild to life-threatening disease. The remaining 85 to 90% of the children are asymptomatic at birth, but 10% of them will develop complications later on, mainly neurodevelopmental defects and sensorineural hearing loss. Among pregnant women with recurrent infection, the rate of transmission to the infant is about 1%. Despite a preexisting immunity in the mother, epidemiological data suggest that the frequency and the severity of symptoms might be in the same range as those for a primary CMV infection (11,12).The issue of whether pregnant women should be screened for CMV during pregnancy has been debated for many years, but no consensus has been agreed upon (6). None of the current international guidelines recommend routine serologic screening of pregnant women (1,7,16,23,26). Indeed, there is no prognostic marker in the mother to predict whether the virus will be transmitted to the fetus (32). To obtain more information, invasive prenatal diagnostic techniques, such as amniocentesis or cordocentesis, have been used. Moreover, CMV infection of the fetus can lead to a great variety of clinical and biological conditions, but there is no reliable marker that can be used to predict which infected fetuses will have serious sequelae (32, 33). Finally, no vaccine or prophylactic therapy is available at present (24, 32). Nigro et al. examined whether CMV-specific hyperimmune globulin therapy could be useful for the prevention and treatment of congenital CMV infection, yet the results of the study did not allow any conclusions to be drawn (28). Despite the drawbacks of the diagnosis and treatment of a congenital CMV infection, gynecologists do screen their patients for CMV (18). Supporters of routine prenatal screening argue that the use of precautionary hygienic measures can be suggested to CMV-seronegative pregnant women. Otherwise, the k...