Prevalence and characterization of astroviruses in Argentinean children with acute gastroenteritis

Among viral agents causing gastroenteritis, human astroviruses (HAstVs) take second or third place, after rotaviruses and caliciviruses, as the most frequent cause of illness. The aims of this study were to determine the prevalence of HAstV infection and to characterize the circulating HAstV strains in children with diarrhea under 3 years of age treated between 1995 and 1998 at out- or in-patient facilities of the children's hospital in Mendoza, Argentina. Reverse transcription-polymerase chain reaction (RT-PCR) and enzyme immunoassay (EIA) were used to detect HAstVs in stool specimens. Positive specimens were tested further by EIA and/or sequenced to type detected HAstV strains. HAstVs were detected in 40 (3.7%) of 1,070 samples that were rotavirus and calicivirus-negative: 14 (3.5%) of 402 from outpatients and 26 (3.9%) of 668 from inpatients. HAstV infection tended to be more severe in children during their first year of life: 18 (4.7%) of 383 HAstV-positive children 0-11 months old were hospitalized versus 8 (2.8%) of 285 children 1 year of age or older (P = 0.29). Type 1 (HAstV-1) was the most common type (41%), followed by HAstV-4 (25%), HAstV-2 (13%), HAstV-3 (13%), and HAstV-5 (8%). In this first epidemiological study of HAstV infection in this region, we confirmed HAstV to be a cause of severe gastroenteritis in children, more often among children younger than 12 months of age. HastV-4 caused 25% of HastV infections in Mendoza, although it has been detected commonly elsewhere. Distinct genetic lineages were apparent but their epidemiological significance remains to be demonstrated.