PATH, Seattle, WA, USA.
Vaccine. 2012 Apr 27;30 Suppl 1:A131-9. doi: 10.1016/j.vaccine.2011.10.002.
Of the estimated half-million deaths from rotavirus globally each year, approximately one-third (N = 160,000 deaths) occur in the Indian subcontinent (defined as India, Bangladesh, and Pakistan). Two commercial vaccines are available for use and recommended by WHO, although the prohibitive vaccine price has limited their introduction into routine childhood immunization programs. New rotavirus vaccines are in late clinical development, including two advanced candidates in India. As significant shifts in rotavirus strain diversity have occurred in the past three decades and questions remain regarding whether strain replacement may occur following introduction of rotavirus vaccines, it is important to understand the temporal and regional strain diversity profile before vaccine introduction. We reviewed 33 peer-reviewed manuscripts from the Indian subcontinent and found that the most common G-types (G1-4) and P-types (P[4] and P[8]) globally accounted for three-fourths of all strains in the subcontinent. However, strains varied by region, and temporal analysis showed the decline of G3 and G4 in recent years and the emergence of G9 and G12. Our findings underscore the large diversity of rotavirus strains in the Indian subcontinent and highlight the need to conduct surveillance on a regional scale to better understand strain diversity before and after rotavirus vaccine introduction.
在全球每年估计有 50 万例轮状病毒死亡病例中，约有三分之一（N=160000 例死亡）发生在印度次大陆（定义为印度、孟加拉国和巴基斯坦）。世卫组织推荐使用两种商业疫苗，但由于疫苗价格昂贵，限制了它们被纳入常规儿童免疫接种计划。两种新的轮状病毒疫苗正在进行后期临床开发，其中包括印度的两种候选疫苗。由于过去三十年来轮状病毒株的多样性发生了重大变化，并且对于疫苗引入后是否会发生株替换仍存在疑问，因此在引入疫苗之前了解轮状病毒株的时间和地域多样性特征非常重要。我们审查了来自印度次大陆的 33 篇同行评审的论文，发现最常见的 G 型（G1-4）和 P 型（P[4]和 P[8]）占该次大陆所有毒株的四分之三。然而，不同地区的毒株存在差异，时间分析显示 G3 和 G4 近年来有所下降，而 G9 和 G12 的出现。我们的研究结果强调了印度次大陆轮状病毒株的多样性很大，并强调需要在区域范围内进行监测，以便在引入轮状病毒疫苗之前和之后更好地了解株多样性。
