Human milk oligosaccharides, oral rotavirus vaccine seroconversion, and rotavirus gastroenteritis risk in a vaccinated birth cohort
Abstract
Objective Rotavirus is the leading cause of diarrhea-related mortality in children worldwide and oral rotavirus vaccines (ORVs) have a lower effectiveness in low- and middle-income countries as compared to high-income countries. Novel strategies that leverage nature's existing system of protection against rotavirus, such as from human milk, could guide future interventions to reduce global rotavirus burden. The goal of this study was to understand whether human milk oligosaccharides (HMOs) influence ORV response and the risk of rotavirus gastroenteritis in early life. Methods In a population-based cohort of 297 Nicaraguan infants followed weekly for 3 years, we assessed the relationships between HMO composition, IgA seroconversion after ORV, and subsequent rotavirus gastroenteritis incidence. Results Among all children, 17.5% experienced [≥] 1 symptomatic rotavirus gastroenteritis episode over 36 months of follow-up. Of the 297 children assessed through serology, only 34.7% seroconverted to the vaccine strain G1P[8]. Seroconverters experienced rotavirus gastroenteritis later and less frequently than non-seroconverters. Receiving milk with higher concentrations of 2'-fucosyllactose (2'FL) was associated with a greater likelihood of seroconversion to ORV. In contrast, receiving milk with several other fucosylated and sialylated HMOs was associated with decreased seroconversion to ORV. Additionally, receiving milk with higher concentrations of DFLNH (Difucosyllacto-N-hexaose)…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 297 participants or records.
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