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健康成年人诺如病毒无症状感染的随访评估:一项前瞻性匹配队列研究。

Follow-up evaluation for norovirus asymptomatic infection among healthy adults: a prospective matched cohort study.

机构信息

Division of General Internal Medicine, Department of Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.

Fujita Health University, Toyoake, Japan.

出版信息

Infect Dis (Lond). 2023 Feb;55(2):108-115. doi: 10.1080/23744235.2022.2134447. Epub 2022 Oct 22.

Abstract

OBJECTIVES

No study has evaluated the follow-up of asymptomatic norovirus infection among healthy adults. This study compared norovirus detection rates between previously known norovirus-positive and norovirus-negative adults without diarrheal symptoms, and evaluated reinfection risk among the previously-norovirus-positive group, and new asymptomatic norovirus infection risk among the previously-norovirus-negative group after 600 days.

METHODS

This prospective age- and sex-matched cohort study, conducted in 2019 at a Japan teaching hospital, included apparently healthy asymptomatic adults with a positive norovirus result and those with a negative result (ratio 1:3) during the 2016-2017 screening. The primary outcome was real-time reverse-transcription polymerase chain reaction-confirmed norovirus in stool specimens. We evaluated descriptive statistics and associated factors, including demographics, social habits, and clinical parameters.

RESULTS

Of 288 participants [mean age, 59.9 (standard deviation: 12.6) years; male, 143 (49.7%)], 73 [genogroup (G) I 35; GII 37; both included 1 each] were positive for norovirus previously, while 215 were negative. After a median of 599 (interquartile range 515-799) days between baseline screening and follow-up, 14 (4.9%; GI 0; GII 14) tested positive for norovirus (2.7% and 5.6% among positive- and negative-norovirus groups at baseline, respectively). Among previously norovirus-negative participants, being older, having elevated blood pressure and haemoglobin A1c level, and drinking Japanese sake at baseline were associated with positive results at follow-up.

CONCLUSIONS

Genogroup homotypic protective effect may exist for subsequent asymptomatic infection. There may be higher risks of future asymptomatic norovirus infection in previously no-norovirus asymptomatic infection people with specific lifestyles or medical histories. SUMMARYThe detection follow-up rates of norovirus were 2.7% and 5.6% among asymptomatic adults with positive- and negative-norovirus status at baseline, respectively. Specific lifestyles or medical histories may confer higher risk of norovirus detection.

摘要

目的

目前尚无研究评估无症状诺如病毒感染的随访情况。本研究比较了无腹泻症状的既往诺如病毒阳性和阴性的健康成年人的诺如病毒检出率,并评估了既往诺如病毒阳性组的再感染风险,以及既往诺如病毒阴性组在 600 天后新发无症状诺如病毒感染的风险。

方法

这是一项前瞻性的年龄和性别匹配队列研究,于 2019 年在日本一家教学医院进行,纳入了在 2016-2017 年筛查期间粪便标本诺如病毒实时逆转录聚合酶链反应阳性且无症状的健康成年人(阳性结果与阴性结果的比例为 1:3)。主要结局是粪便标本中实时逆转录聚合酶链反应确认的诺如病毒。我们评估了描述性统计数据和相关因素,包括人口统计学、社会习惯和临床参数。

结果

288 名参与者[平均年龄 59.9(标准差:12.6)岁;男性 143 名(49.7%)]中,73 名(G Ⅰ 35 例;G Ⅱ 37 例;两者均包含 1 例)既往诺如病毒阳性,215 名既往诺如病毒阴性。在基线筛查和随访之间中位数为 599(四分位距 515-799)天之后,14 名(4.9%;GI 0;GⅡ 14)检测到诺如病毒阳性(基线时阳性和阴性诺如病毒组的阳性检出率分别为 2.7%和 5.6%)。在既往诺如病毒阴性的参与者中,年龄较大、血压和血红蛋白 A1c 水平升高以及基线时饮用日本清酒与随访时的阳性结果相关。

结论

同种基因型的诺如病毒可能具有保护作用,防止随后发生无症状感染。对于既往无症状感染且具有特定生活方式或病史的人,可能存在未来发生无症状诺如病毒感染的更高风险。

总结

在基线时诺如病毒阳性和阴性的无症状成年人中,诺如病毒的检出率分别为 2.7%和 5.6%。特定的生活方式或病史可能会增加诺如病毒检测的风险。

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