Association Between Population-Level Secretor Status Prevalence and Genogroup 2 Genotype 4 Norovirus Prevalence Open Access
Arrouzet, Cory (Spring 2018)
Abstract
Noroviruses are the leading cause of acute gastroenteritis worldwide. The GII.4 genotype has been the dominant genotype worldwide since its global emergence in 1994. Individuals with a functional FUT2 gene, termed secretors, have consistently shown increased susceptibility to certain noroviruses, including GII.4. To investigate the association between population level secretor status and GII.4 prevalence, we conducted a systematic literature review of studies reporting norovirus genotypes in outbreaks or sporadic cases for which we had data on secretor prevalence from a prior systematic review. 2528 references were identified from searching the literature. 219 genotype and 112 secretor studies with data from 38 countries were included in the final analysis. Using inverse variance-weighted linear regression modeling, we observed a significant, positive association between country-level secretor and GII.4 prevalence. An increase in secretor prevalence is associated with a 0.60% (95% CI: 0.11, 1.08) increase in GII.4 prevalence, controlling for study type, age of patients, pandemic variant period, and Human Development Index. These results have implications for vaccine interventions and future research to understand the effects of population level host genetic heterogeneity on country level genotype distributions.
Table of Contents
Chapter I: Background and Literature Review...........................................................1
Introduction ................................................................................................................1
Burden and Epidemiology...........................................................................................1
Genetic and Molecular Epidemiology .........................................................................4
Host Genetic Susceptibility and Resistance.................................................................8
Summary ..................................................................................................................10
Chapter II: Manuscript...............................................................................................12
Abstract .................................................................................................................... 12
Introduction .............................................................................................................. 13
Methods .................................................................................................................... 15
Results ...................................................................................................................... 20
Discussion ................................................................................................................24
References ................................................................................................................ 27
Tables.......................................................................................................................35
Figures...................................................................................................................... 39
Chapter III: Public Health Implications and Future Directions ..............................43
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