Diagnosis of rotavirus infection in a vaccinated population: Is a less sensitive immunochromatographic method more suitable for detecting wild-type rotavirus than real-time RT-PCR?

Yandle, Zoe; Coughlan, Suzie; Drew, Richard J.; Cleary, Jennifer; Gascun, Cillian De

doi:10.1016/j.jcv.2018.10.006

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…The live-attenuated vaccine Rotarix replicates in the gut of the recipient and is excreted, albeit at lower amounts compared to a wild-type infection [ 35 ]. We detected Rotarix in 10% of patients who were of vaccine-eligible age and, as rotavirus is notifiable in Ireland, this highlights the importance of differentiating between wild-type and vaccine-derived viruses, particularly when screening with a sensitive method, such as RT-PCR.…”

Section: Discussionmentioning

confidence: 99%

Group A Rotavirus Detection and Genotype Distribution before and after Introduction of a National Immunisation Programme in Ireland: 2015–2019

et al. 2020

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Immunisation against rotavirus infection was introduced into Ireland in December 2016. We report on the viruses causing gastroenteritis before (2015–2016) and after (2017–2019) implementation of the Rotarix vaccine, as well as changes in the diversity of circulating rotavirus genotypes. Samples from patients aged ≤ 5 years (n = 11,800) were received at the National Virus Reference Laboratory, Dublin, and tested by real-time RT-PCR for rotavirus, Rotarix, norovirus, sapovirus, astrovirus, and enteric adenovirus. Rotavirus genotyping was performed either by multiplex or hemi-nested RT-PCR, and a subset was characterised by sequence analysis. Rotavirus detection decreased by 91% in children aged 0–12 months between 2015/16 and 2018/19. Rotarix was detected in 10% of those eligible for the vaccine and was not found in those aged >7 months. Rotavirus typically peaks in March–May, but following vaccination, the seasonality became less defined. In 2015–16, G1P[8] was the most common genotype circulating; however, in 2019 G2P[4] was detected more often. Following the introduction of Rotarix, a reduction in numbers of rotavirus infections occurred, coinciding with an increase in genotype diversity, along with the first recorded detection of an equine-like G3 strain in Ireland.

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Section: Discussionmentioning

confidence: 99%

Group A Rotavirus Detection and Genotype Distribution before and after Introduction of a National Immunisation Programme in Ireland: 2015–2019

et al. 2020

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“…Twelve studies with 4407 participants were retrieved [17][18][19][20][21][22][23][24][25][26][27][28]. Figure 1 illustrates the literature search, and Table 1 presents the detailed characteristics of the studies.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of rotavirus antigen tests in children: A systematic review and meta‐analysis

Hung¹,

Chen²

2023

Tropical Med Int Health

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Objectives: Rotavirus infection is the leading cause of acute gastroenteritis (AGE) in children. Children with rotavirus infection may have symptoms such as diarrhoea or vomiting. Diarrheal diseases caused by rotavirus and other enteric pathogens cannot be differentiated on the basis of clinical symptoms. Therefore, diagnostic testing is essential to confirm a diagnosis of rotavirus infection. The aim of the meta-analysis is to evaluate the diagnostic accuracy of immunochromatographic rotavirus antigen tests in children. Methods: We searched the PubMed, Embase, Cochrane Library and Google Scholar databases for studies evaluating the diagnostic accuracy of antigen tests for rotavirus in children. We included studies that provided sufficient data to construct a 2 Â 2 table on a per patient basis. The overall sensitivity and specificity of the antigen tests were determined using a bivariate random-effects model. Results: In total, 12 studies with 4407 participants were included in the study. The meta-analysis yielded a pooled sensitivity of 89.2% (95% confidence interval [CI]: 77.4%-95.3%) and pooled specificity of 93.2% (95% CI: 83.8%-97.3%). A subgroup analysis of such tests in children aged ≤5 years yielded a pooled sensitivity of 87.1% and pooled specificity of 91.8%. Another subgroup analysis of high-quality studies involving 820 participants yielded a pooled sensitivity of 92.3% and pooled specificity of 95.2%. Conclusions: Rotavirus antigen tests have high sensitivity for the diagnosis of rotavirus infection in children with AGE. In addition, such tests may be effective for the identification and clinical management of rotavirus infection in children and the prevention of disease progression.

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“…In the choice of a RoV test, it is also important to take into account that molecular assays are able to detect the attenuated RoV strains used in the vaccines, and thus an overdiagnosis of RoV infections in pediatric patients could occur. In a recent study C t values were significantly lower for wild-type RoV compared to detectable Rotarix strain, suggesting that in a vaccinated pediatric population a less sensitive test could have higher specificity and negative predictive value (Yandle et al 2018). These observations highlight the importance that diagnostic laboratories select C t cut-off values based on the specific molecular assay used in order to better aid clinical patient management.…”

Section: Discussionmentioning

confidence: 97%

Comparative analysis of 2 commercial molecular tests for the detection of gastroenteric viruses on stool samples

Sciandra

Piccioni

Coltella

et al. 2020

Diagnostic Microbiology and Infectious Disease

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Objective: Our purpose was to compare the performance of 2 recently introduced molecular tests for the identification of gastrointestinal viral infections. Methods: One hundred fecal samples from pediatric patients were analyzed using 2 workflows, each including nucleic acids extraction and multiplex Real-Time PCR: Allplex™ GI-Virus Assay and FTD Viral gastroenteritis. The agreement was evaluated calculating Cohen's kappa and applying McNemar's test. Results and conclusion: Allplex and FTD assays showed 100% overall agreement for Norovirus GI/GII and Sapovirus (κ: 1.00), and 99% for Astrovirus (κ: 0.66). A lower agreement was detected for Adenovirus (89%; κ: 0.72) and Rotavirus (91%, k: 0.53), owing to samples resulted positive only with FTD test. The discrepancies were attributed to a different efficiency of extraction/amplification and to the different Adenovirus serotype specificity of the tests since Allplex detects only AdVF40 and AdVF41. FTD test should be used when non enteric adenovirus could have a clinical significance.

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Diagnosis of rotavirus infection in a vaccinated population: Is a less sensitive immunochromatographic method more suitable for detecting wild-type rotavirus than real-time RT-PCR?

Cited by 4 publications

References 14 publications

Group A Rotavirus Detection and Genotype Distribution before and after Introduction of a National Immunisation Programme in Ireland: 2015–2019

Group A Rotavirus Detection and Genotype Distribution before and after Introduction of a National Immunisation Programme in Ireland: 2015–2019

Diagnostic accuracy of rotavirus antigen tests in children: A systematic review and meta‐analysis

Comparative analysis of 2 commercial molecular tests for the detection of gastroenteric viruses on stool samples

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