Rotavirus infections linked to celiac disease

NEW YORK (Reuters Health) - Results of a study provide evidence that repeated rotavirus infections may increase the risk of celiac disease in genetically susceptible children.

The finding hints that "potentially preventable gastrointestinal infection may contribute to the initiation of celiac disease pathogenesis," researchers write in the American Journal of Gastroenterology.

Intestinal infections have long been thought to contribute to the development of celiac disease, a common digestive disorder triggered by eating wheat products and other foods containing the protein gluten. Few studies, however, have looked at the role of specific infectious agents in the development of the disease.

Rotavirus is the leading cause of severe diarrhea in infants and young children and kills roughly 500,000 children a year globally. In the US, it affects 2.7 million children in an average year and 75 percent of children get diarrhea from rotavirus by their 5th birthday.

As participants in a study of the natural history and environmental triggers of diabetes and celiac disease, 1,931 children from the Denver metropolitan area who are genetically susceptible to celiac disease were monitored from infancy for rotavirus infection and the development of celiac disease autoimmunity -- an erroneous immune reaction against "self" proteins.

Each "study" child was matched to two "control" children.

Dr. Marian Rewers from the University of Colorado School of Medicine in Aurora and colleagues report that 54 study children developed celiac disease autoimmunity at a median of 4.4 years of age. Thirty-six of these children had an intestinal biopsy, of which 27 (75 percent) were positive for celiac disease.

According to the team, frequent rotavirus infections predicted a higher risk of celiac disease autoimmunity. The rate ratio for celiac autoimmunity was 1.94 for one rotavirus infection and 3.76 for two or more rotavirus infections compared with zero rotavirus infections.

Adjustment for multiple potentially confounding factors did not alter the findings.

The current study "provides the first indication that a high frequency of rotavirus infections may increase the risk of celiac disease autoimmunity in childhood in genetically predisposed individuals."

SOURCE: American Journal of Gastroenterology, October 2006.