Evaluating the Use of Immunoglobulins A and G Independently As Correlates of Protection Against Rotavirus Gastroenteritis Public

Abstract

Background: Rotavirus is the leading cause of acute gastroenteritis in infants worldwide. Use of correlates of protection for rotavirus gastroenteritis would facilitate development of next generation rotavirus vaccines. We aimed to assess the thresholds of antirotavirus Immunoglobulin A and Immunoglobulin G units as correlates of protection that best predict the reduced risk of rotavirus gastroenteritis. 

Methods: We used data from a total of 1304 infants collected in the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development, (MAL-ED) study. Logistic regression analyses were employed to estimate the odds ratios (ORs) describing the relationship between IgA and IgG thresholds and occurrence of rotavirus gastroenteritis.

Results: For IgA, odds ratios (ORs) ranged from 0.63 (95% CI =0.46, 0.86) for participants with IgA antibodies ≥ 20 U/mL to 0.467 (95% CI=0.174, 1.048) for participants with IgA antibodies ≥640 U/mL. Taken together, these results show that the increase in IgA threshold resulted in increased protection from rotavirus gastroenteritis. Similarly, for IgG, ORs ranged from 0.68 (95% CI= 0.423, 1.270) for participants with IgG antibodies ≥ 20 U/mL to 0.522 (95% CI=0.31, 0.88) for participants with IgG antibodies ≥640 U/mL, showing the increase in IgG threshold resulted in increased protection from rotavirus gastroenteritis.

Discussion: Although no clear pattern of protection was identified for IgA and IgG threshold models in a non-stratified analysis, the lowest OR was associated with the highest threshold (≥640) of IgA and IgG both in our overall (non-stratified) and stratified analyses. Our results highlight that higher antirotavirus IgA and IgG levels provided better protection against the occurrence of rotavirus gastroenteritis in unvaccinated children of the MAL-ED cohort.

 

Table of Contents

Introduction………………………………………………………………………………………1 

Methods…………………………………………………………………………………………...3

  Data Collection………………………………………………………………………………….3

  Statistical Analysis………………………………………………………………………………4 

Results…………………………………………………………………………………………….5

 Descriptive analysis……………………………………………………………………………...5

  Overall Logistic regression analyses……………………………………………………………………6

 Stratified Analyses…………………………………………………………………………………………7

Discussion………………………………………………………………………………………...8

 Key Findings……………………………………………………………………………………..8

 Strengths…………………………………………………………………………………………9

 Limitations……………………………………………………………………………………….9

 Implications……………………………………………………………………………………..10

 Future steps……………………………………………………………………………………...10 

Tables & Figures

  Table 1 ………………………………………………………………………………………...11

  Table 2…………………………………………………………………………………………12

  Figure 1 ………………………………………………………………………………………..13

  Figure 2A………………………………………………………………………………………14

  Figure 2B………………………………………………………………………………………14

  Table 3…………………………………………………………………………………………14

  Figure 3A………………………………………………………………………………………15

  Figure 3B………………………………………………………………………………………15

  Figure 4A………………………………………………………………………………………16

  Figure 4B………………………………………………………………………………………16

  Table 4…………………………………………………………………………………………17

  Table 5…………………………………………………………………………………………17 

References……………………………………………………………………………………….18

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health Environmental Health
Mot-clé	rotavirus immunoglobulin G correlate of protection gastroenteritis immunoglobulin A
Committee Chair / Thesis Advisor	Dr. Benjamin Lopman, Emory University
Committee Members	Avnika Amin, Emory University Alex Edwards, Emory University Elizabeth Sajewski, Emory University

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