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Chronic persistent Norovirus in the immune-compromised host.
Anna Smielewska1, Paraskevi Klotsas2, Effrossyni Gkrania-Klotsas3
1Clatterbridge Cancer Hospital, Alder Hey Children's Hospital and University of Liverpool Honorary Senior Lecturer Infection Biology & Microbiomes, LCL/CSSB, Liverpool University Hospital Foundation Trust, Royal Liverpool Site, Liverpool.
Current Opinion in Infectious Diseases
|March 13, 2026
Summary
Chronic norovirus infection is a growing concern in immunocompromised patients, leading to significant illness. Current treatments are limited, highlighting the need for new antiviral therapies and vaccines.
Area of Science:
- Immunology
- Virology
- Gastroenterology
Background:
- Norovirus is a leading cause of acute gastroenteritis worldwide.
- Chronic norovirus infection is increasingly recognized in immunocompromised individuals.
Purpose of the Study:
- To review the latest evidence on the pathogenesis, clinical features, and management of chronic norovirus infection.
- To highlight challenges in diagnosis and treatment for this vulnerable population.
Main Methods:
- Literature review of recent studies on chronic norovirus infection.
- Analysis of host immune response, particularly T cell function, in viral clearance.
- Evaluation of current and investigational therapeutic options.
Main Results:
- Persistent norovirus shedding is observed in various immunocompromised states.
- Chronic infection causes significant morbidity, including malnutrition.
- T cell immunity is crucial for viral clearance.
- Limited efficacy of current treatments (ribavirin, nitazoxanide, immunoglobulin); favipiravir is under investigation.
- Diagnostic challenges exist due to overlapping histopathology with other enteropathies.
Conclusions:
- Chronic norovirus infection in the immunocompromised is under-recognized and challenging to treat.
- Development of evidence-based antiviral therapies is crucial.
- Effective vaccines are needed to reduce long-term morbidity.
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