Fernández Juan Manuel Ribes, Gómez Javier Buesa
Departamento de Microbiología y Ecología, Universidad de Valencia, España.
Enferm Infecc Microbiol Clin. 2010 Jan;28 Suppl 1:51-5. doi: 10.1016/S0213-005X(10)70009-4.
Noroviruses infect persons of all ages, often causing epidemic outbreaks of acute gastroenteritis as well as sporadic cases. The application of novel molecular methods to the diagnosis of norovirus infections is now revealing their real impact. Molecular epidemiology studies have identified the most common viral genotypes responsible for human infections. Norovirus gastroenteritis is usually mild and of short duration, although the disease can also be severe, especially in the elderly, or may become chronic, as occurred in the immunocompromised patients. Several factors have been identified regarding the differential susceptibility to norovirus infection among individuals, consisting of several histo-blood antigens (ABO, Lewis and secretor) that are involved in the binding process of noroviruses to the enterocytes. The expression of these antigens in humans is genetically encoded, and shows a high polymorphism, which combined with the genetic diversity of noroviruses, makes the virus-host relationship rather complex. The diagnosis of norovirus infections is not performed routinely in many laboratories, but those involved in epidemiological surveillance have identified norovirus strains that evolve sequentially over time, similarly to Influenza viruses.
诺如病毒可感染所有年龄段的人群，常引发急性胃肠炎的流行暴发以及散发病例。新型分子方法在诺如病毒感染诊断中的应用正揭示其实际影响。分子流行病学研究已确定了导致人类感染的最常见病毒基因型。诺如病毒胃肠炎通常症状较轻且病程较短，不过该疾病也可能较为严重，尤其是在老年人中，或者可能会变为慢性，免疫功能低下的患者就曾出现这种情况。已确定了个体对诺如病毒感染易感性差异的几个因素，包括几种组织血型抗原（ABO、Lewis和分泌型），它们参与诺如病毒与肠上皮细胞的结合过程。这些抗原在人类中的表达由基因编码，且具有高度多态性，再加上诺如病毒的遗传多样性，使得病毒与宿主的关系相当复杂。许多实验室并非常规进行诺如病毒感染的诊断，但参与流行病学监测的人员已识别出随着时间推移会依次演变的诺如病毒株，这与流感病毒类似。
