The association between ABO blood groups and norovirus infections among patients suffering from diarrheal disease in Northwest Ethiopia

Abstract

Background: Norovirus (NoV) infection is a significant cause of diarrhea worldwide. However, all individuals are not equally affected due to environmental, viral, and host factors, particularly ABO blood groups. Indeed, data that describes the association between NoV infection and the ABO blood group is limited in Ethiopia, and this needs to be investigated.

Objective: This study aimed to assess the relationship between ABO blood groups and NoV infection in Northwest Ethiopia.

Method: A health-facility-based cross-sectional study was conducted from May 2021 to November 2021 by enrolling 550 participants with diarrhea. Fecal samples were collected and analyzed by reverse transcription PCR to identify NoVs. To further genotype the positive samples, a viral protein-1-coding gene was sequenced. In addition, blood samples were collected and tested to identify blood groupsby using the tube hemagglutination technique. The data were analyzed using SPSS version 23. Logistic regression analysis was done to assess the association between NoV infection and the independent variables.

Result: Among the 550 enrolled participants, 519 (94% response rate) provided the required clinical samples and epidemiological data. The majority of the study participants (249/519; 48%) had O blood group.Among the NoV-positive study subjects, the majority (34/46, 74%) were in blood group O, followed by blood group A individuals (9/46, 19.6%).The risk of NoV infection was higher for patients with blood group O than for blood group B (AOR = 1.5, 95%CI = 2–15, P= 0.01), but there was no association for other blood groups.At least one NoV-GII was identified in each of the blood groups, while NoV-GI affected individuals with blood groups O and A. Besides, GII.3 and GII.21 genotypes were common among blood group O individuals, while most (75%) blood group A individuals were susceptible to GII.17 infections.

Conclusion: The positivity rate of NoV infection was considerably high among individuals with blood group O. Norovirus-GII can infect all blood groups, while NoV-GI selectively affects blood groups A and O. Further large-scale studies are warranted to assess the relevance of this observation and other genetic factors.