The Impact of Rotavirus Vaccines on Genotype Diversity: A Comprehensive Analysis of 2 Decades of Australian Surveillance Data

Roczo-Farkas, Susie; Kirkwood, Carl D.; Cowley, Daniel; Barnes, Graeme L.; Bishop, Ruth F.; Bogdanovic-Sakran, Nada; Boniface, Karen; Donato, Celeste; Bines, Julie E

doi:10.1093/infdis/jiy197

Cited by 93 publications

(166 citation statements)

References 44 publications

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“…When larger data sets can be assembled, it will be informative to determine the relationships between differences in vaccination probabilities and rotavirus G and P types based on the type of vaccine (RV1 or RV5) administered. Recently published data from Australia show increased G12P [8] prevalence in states using RV5 and increased G2P [4] and equine G3P [8] prevalence in states and territories using RV1, supporting the idea that the two vaccines apply different selective immunological pressures that influence circulating rotavirus population diversity (81). Modeling suggests that differences in homotypic and heterotypic protection from vaccination can influence genotype selection, particularly for RV1 (82).…”

Section: Discussionmentioning

confidence: 90%

Multiple Introductions and Antigenic Mismatch with Vaccines May Contribute to Increased Predominance of G12P[8] Rotaviruses in the United States

Ogden

Tan

Akopov

et al. 2019

J Virol

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Rotavirus is the leading global cause of diarrheal mortality for unvaccinated children under 5 years of age. The outer capsid of rotavirus virions consists of VP7 and VP4 proteins, which determine viral G and P types, respectively, and are primary targets of neutralizing antibodies. Successful vaccination depends upon generating broadly protective immune responses following exposure to rotaviruses presenting a limited number of G- and P-type antigens. Vaccine introduction resulted in decreased rotavirus disease burden but also coincided with the emergence of uncommon G and P genotypes, including G12. To gain insight into the recent predominance of G12P[8] rotaviruses in the United States, we evaluated 142 complete rotavirus genome sequences and metadata from 151 clinical specimens collected in Nashville, TN, from 2011 to 2013 through the New Vaccine Surveillance Network. Circulating G12P[8] strains were found to share many segments with other locally circulating strains but to have distinct constellations. Phylogenetic analyses of G12 sequences and their geographic sources provided evidence for multiple separate introductions of G12 segments into Nashville, TN. Antigenic epitopes of VP7 proteins of G12P[8] strains circulating in Nashville, TN, differ markedly from those of vaccine strains. Fully vaccinated children were found to be infected with G12P[8] strains more frequently than with other rotavirus genotypes. Multiple introductions and significant antigenic mismatch may in part explain the recent predominance of G12P[8] strains in the United States and emphasize the need for continued monitoring of rotavirus vaccine efficacy against emerging rotavirus genotypes. IMPORTANCE Rotavirus is an important cause of childhood diarrheal disease worldwide. Two immunodominant proteins of rotavirus, VP7 and VP4, determine G and P genotypes, respectively. Recently, G12P[8] rotaviruses have become increasingly predominant. By analyzing rotavirus genome sequences from stool specimens obtained in Nashville, TN, from 2011 to 2013 and globally circulating rotaviruses, we found evidence of multiple introductions of G12 genes into the area. Based on sequence polymorphisms, VP7 proteins of these viruses are predicted to present themselves to the immune system very differently than those of vaccine strains. Many of the sick children with G12P[8] rotavirus in their diarrheal stools also were fully vaccinated. Our findings emphasize the need for continued monitoring of circulating rotaviruses and the effectiveness of the vaccines against strains with emerging G and P genotypes.

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Section: Discussionmentioning

confidence: 90%

Multiple Introductions and Antigenic Mismatch with Vaccines May Contribute to Increased Predominance of G12P[8] Rotaviruses in the United States

Ogden

Tan

Akopov

et al. 2019

J Virol

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“…The introduction of RVA vaccines might have globally affected the ecology of RVA infections. In Australia, increased diversity and differences in genotype predominance have been observed: G12P[8] strains in states using RotaTeq and G2P[4] strains and equine‐like G3P[8] strains in states using Rotarix . There is the controversial question of whether vaccination facilitated the emergence of unusual strains including equine‐like G3P[8] strains through selective pressure.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of equine‐like G3P[8] rotavirus in children and adults with acute gastroenteritis in Thailand

Tacharoenmuang

Komoto

Guntapong

et al. 2019

Journal of Medical Virology

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Group A rotavirus (RVA) is a major cause of acute gastroenteritis in infants and young children worldwide. This study aims to clarify the distribution of G/P types and genetic characteristics of RVAs circulating in Thailand. Between January 2014 and September 2016, 1867 stool specimens were collected from children and adults with acute gastroenteritis in six provinces in Thailand. RVAs were detected in 514/1867 (27.5%) stool specimens. G1P[8] (44.7%) was the most predominant genotype, followed by G3P[8] (33.7%), G2P[4] (11.5%), G8P[8] (7.0%), and G9P[8] (1.3%). Unusual G3P[9] (0.8%), G3P[10] (0.4%), G4P[6] (0.4%), and G10P[14] (0.2%) were also detected at low frequencies. The predominant genotype, G1P[8] (64.4%), in 2014 decreased to 6.1% in 2016. In contrast, the frequency of G3P[8] markedly increased from 5.5% in 2014 to 65.3% in 2015 and 89.8% in 2016. On polyacrylamide gel electrophoresis, most (135/140; 96.4%) of the G3P[8] strains exhibited a short RNA profile. Successful determination of the nucleotide sequences of the VP7 genes of 98 G3P[8] strains with a short RNA profile showed that they are all equine‐like G3P[8] strains. On phylogenetic analysis of genome segments of two representative Thai equine‐like G3P[8] strains, it was noteworthy that they possessed distinct NSP4 genes, one bovine‐like and the other human‐like. Thus, we found that characteristic equine‐like G3P[8] strains with a short RNA electropherotype are becoming highly prevalent in children and adults in Thailand.

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“…In Australia, genotype G2 increased in the state in which RV1 was introduced and G12 increased in the state in which RV5 was introduced, but after that, no definite trends were observed. [26][27][28][29] In Tsu and Ise in Mie prefecture in Japan, the dominant genotype shifted from G3P [8] to G1P [8] and G2P [4] after vaccine introduction. 30 It is therefore clear that no consistent trend in RV genotype changes was observed after the introduction of RV vaccine.…”

Section: Discussionmentioning

confidence: 99%

Rotavirus genotype and Vesikari score of outpatients in Japan in the vaccine era

Ono

Tsugawa

Nakata³

et al. 2020

Pediatrics International

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Background: Group A rotaviruses (RVs) are a major cause of severe gastroenteritis among infants and young children. In Japan, RV vaccines were introduced in 2011, leading to a reduction in severe gastroenteritis cases. Studies are required to assess the effectiveness of the vaccines and their effect on the prevalence of RV genotypes. Methods: Fecal samples were collected from outpatients with RV gastroenteritis in a pediatric clinic in Sapporo, Japan, from 2010 to 2016. GPI genotypes were determined using reverse-transcription polymerase chain reaction. Clinical information and immunization records were obtained from outpatients after 2013. GPI genotypes and clinical features were compared between patients with and without a RV vaccine history. Results: In total, 270 cases were genotyped. G1P[8]I1 (Wa-like G1P[8]) strains were dominant from 2010 to 2012. G1P[8]I2 (DS-1-like G1P[8]) strains appeared in 2012 and dominated in 2013 to 2015. G2P[4]I2 and G9P[8]I1 strains increased every 3 years (G2P[4]I2: 2011 and 2014, G9P[8] I1: 2010, 2013 and 2016). After the 2013 season, 137 cases were collected, 24 of which were vaccinated. Cases requiring drip infusion were fewer in the vaccination group than in the non-vaccination group (16.7% vs 52.2%). No patients required hospitalization in the vaccination group compared with 10.6% in the non-vaccination group. A severe Vesikari score was less common in the vaccination group than in the non-vaccination group (33.3% vs 78.8%). There was no significant difference in the GPI genotype distribution between the two groups. Conclusion: Rotaviruses vaccine effectiveness, regardless of GPI genotype, was confirmed in terms of alleviation of disease severity.

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The Impact of Rotavirus Vaccines on Genotype Diversity: A Comprehensive Analysis of 2 Decades of Australian Surveillance Data

Cited by 93 publications

References 44 publications

Multiple Introductions and Antigenic Mismatch with Vaccines May Contribute to Increased Predominance of G12P[8] Rotaviruses in the United States

Multiple Introductions and Antigenic Mismatch with Vaccines May Contribute to Increased Predominance of G12P[8] Rotaviruses in the United States

High prevalence of equine‐like G3P[8] rotavirus in children and adults with acute gastroenteritis in Thailand

Rotavirus genotype and Vesikari score of outpatients in Japan in the vaccine era

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