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KI and WU Polyomaviruses: Seroprevalence Study and DNA Prevalence in SARS-CoV-2 RNA Positive and Negative Respiratory Samples. Microorganisms 2022; 10:microorganisms10040752. [PMID: 35456801 PMCID: PMC9031565 DOI: 10.3390/microorganisms10040752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/17/2022] Open
Abstract
The aim of this work was to study the possible co-infection of KI and WU polyomavirus (KIPyV and WUPyV, respectively) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory samples and to detect the seroprevalence of KIPyV and WUPyV. A total of 1030 nasopharyngeal samples were analyzed from SARS-CoV-2 RNA positive (n = 680) and negative (n = 350) adults and children (age: 1 day to 94.2 years) collected from August 2020 to October 2021. KIPyV DNA was detected in two SARS-CoV-2-positive samples (2/680, 0.29%) and in three SARS-CoV-2-negative samples (3/350, 0.86%). WUPyV DNA was observed in one-one samples from both groups (1/680, 0.15% vs. 1/350, 0.29%). We did not find an association between SARS-CoV-2 and KIPyV or WUPyV infection, and we found low DNA prevalence of polyomaviruses studied after a long-term lockdown in Hungary. To exclude a geographically different distribution of these polyomaviruses, we studied the seroprevalence of KIPyV and WUPyV by enzyme-linked immunosorbent assay among children and adults (n = 692 for KIPyV and n = 705 for WUPyV). Our data confirmed that primary infections by KIPyV and WUPyV occur mainly during childhood; the overall seropositivity of adults was 93.7% and 89.2% for KIPyV and WUPyV, respectively. Based on our data, we suggest that the spread of KIPyV and WUPyV might have been restricted in Hungary by the lockdown.
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Polyomaviruses shedding in stool of patients with hematological disorders: detection analysis and study of the non-coding control region's genetic variability. Med Microbiol Immunol 2019; 208:845-854. [PMID: 31375897 PMCID: PMC6817764 DOI: 10.1007/s00430-019-00630-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/25/2019] [Indexed: 01/07/2023]
Abstract
Fragmented data are available on the human polyomaviruses (HPyVs) prevalence in the gastrointestinal tract. Rearrangements in the non-coding control region (NCCR) of JCPyV and BKPyV have been extensively studied and correlated to clinical outcome; instead, little information is available for KIPyV, WUPyV and MCPyV NCCRs. To get insights into the role of HPyVs in the gastrointestinal tract, we investigated JCPyV, BKPyV, KIPyV, WUPyV and MCPyV distribution among hematological patients in concomitance with gastrointestinal symptoms. In addition, NCCRs and VP1 sequences were examined to characterize the strains circulating among the enrolled patients. DNA was extracted from 62 stool samples and qPCR was carried out to detect and quantify JCPyV, BKPyV, KIPyV, WUPyV and MCPyV genomes. Positive samples were subsequently amplified and sequenced for NCCR and VP1 regions. A phylogenetic tree was constructed aligning the obtained VP1 sequences to a set of reference sequences. qPCR revealed low viral loads for all HPyVs searched. Mono and co-infections were detected. A significant correlation was found between gastrointestinal complications and KIPyV infection. Archetype-like NCCRs were found for JCPyV and BKPyV, and a high degree of NCCRs stability was observed for KIPyV, WUPyV and MCPyV. Analysis of the VP1 sequences revealed a 99% identity with the VP1 reference sequences. The study adds important information on HPyVs prevalence and persistence in the gastrointestinal tract. Gastrointestinal signs were correlated with the presence of KIPyV, although definitive conclusions cannot be drawn. HPyVs NCCRs showed a high degree of sequence stability, suggesting that sequence rearrangements are rare in this anatomical site.
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Annamalay AA, Abbott S, Sikazwe C, Khoo SK, Bizzintino J, Zhang G, Laing I, Chidlow GR, Smith DW, Gern J, Goldblatt J, Lehmann D, Green RJ, Le Souëf PN. Respiratory viruses in young South African children with acute lower respiratory infections and interactions with HIV. J Clin Virol 2016; 81:58-63. [PMID: 27317881 PMCID: PMC7106452 DOI: 10.1016/j.jcv.2016.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Human rhinovirus (RV) is the most common respiratory virus and has been associated with frequent and severe acute lower respiratory infections (ALRI). The prevalence of RV species among HIV-infected children in South Africa is unknown. OBJECTIVES To describe the prevalence of respiratory viruses, including RV species, associated with HIV status and other clinical symptoms in children less than two years of age with and without ALRI in Pretoria, South Africa. STUDY DESIGN Nasopharyngeal aspirates were collected from 105 hospitalized ALRI cases and 53 non-ALRI controls less than two years of age. HIV status was determined. Common respiratory viruses were identified by PCR, and RV species and genotypes were identified by semi-nested PCR, sequencing and phylogenetic tree analyses. RESULTS Respiratory viruses were more common among ALRI cases than controls (83.8% vs. 69.2%; p=0.041). RV was the most commonly identified virus in cases with pneumonia (45.6%) or bronchiolitis (52.1%), regardless of HIV status, as well as in controls (39.6%). RV-A was identified in 26.7% of cases and 15.1% of controls while RV-C was identified in 21.0% of cases and 18.9% of controls. HIV-infected children were more likely to be diagnosed with pneumonia than bronchiolitis (p<0.01). RSV was not identified in any HIV-infected cases (n=15) compared with 30.6% of HIV-uninfected cases (n=85, p=0.013), and was identified more frequently in bronchiolitis than in pneumonia cases (43.8% vs. 12.3%; p<0.01). CONCLUSIONS RV-A and RV-C are endemic in South African children and HIV infection may be protective against RSV and bronchiolitis.
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Affiliation(s)
- Alicia A Annamalay
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia.
| | - Salome Abbott
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Chisha Sikazwe
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Joelene Bizzintino
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Guicheng Zhang
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; School of Public Health, Curtin University, Perth, Australia
| | - Ingrid Laing
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Glenys R Chidlow
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - David W Smith
- Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Perth, Australia
| | - James Gern
- University of Wisconsin-Madison, Madison, USA
| | - Jack Goldblatt
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Deborah Lehmann
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Robin J Green
- Division of Paediatric Pulmonology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Peter N Le Souëf
- School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
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Rao S, Lucero MG, Nohynek H, Tallo V, Lupisan SP, Garcea RL, Simões EAF. WU and KI polyomavirus infections in Filipino children with lower respiratory tract disease. J Clin Virol 2016; 82:112-118. [PMID: 27479174 DOI: 10.1016/j.jcv.2016.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 07/13/2016] [Accepted: 07/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND WU and KI are human polyomaviruses initially detected in the respiratory tract, whose clinical significance remains uncertain. OBJECTIVES To determine the epidemiology, viral load and clinical characteristics of WU and KI polyomaviruses. STUDY DESIGN We tested respiratory specimens collected during a randomized, placebo-controlled pneumococcal conjugate vaccine trial and related epidemiological study in the Philippines. We analyzed 1077 nasal washes from patients aged 6 weeks to 5 years who developed lower respiratory tract illness using quantitative real-time PCR for WU and KI. We collected data regarding presenting symptoms, signs, radiographic findings, laboratory data and coinfection. RESULTS The prevalence and co-infection rates for WU were 5.3% and 74% respectively and 4.2% and 84% respectively for KI. Higher KI viral loads were observed in patients with severe or very severe pneumonia, those presenting with chest indrawing, hypoxia without wheeze, convulsions, and with KI monoinfection compared with co-infection. There was no significant association between viral load and clinical presentation for WU. CONCLUSIONS These findings suggest a potential pathogenic role for KI, and that there is an association between KI viral load and illness severity.
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Affiliation(s)
- Suchitra Rao
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Marilla G Lucero
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | - Hanna Nohynek
- National Institute for Health and Welfare, Helsinki, Finland
| | - Veronica Tallo
- Research Institute for Tropical Medicine, Department of Health, Muntinlupa City, Metro Manila, Philippines
| | | | | | - Eric A F Simões
- University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA; Center for Global Health, Colorado School of Public Health, Aurora, CO, USA.
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Csoma E, Mészáros B, Asztalos L, Gergely L. WU and KI polyomaviruses in respiratory, blood and urine samples from renal transplant patients. J Clin Virol 2014; 64:28-33. [PMID: 25728075 DOI: 10.1016/j.jcv.2014.12.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/13/2014] [Accepted: 12/27/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is suggested that immunosuppression due to transplantation might be a risk for human polyomavirus KI (KIPyV) and WU (WUPyV) infection. Most of the publications report data about stem cell transplant patients, little is known about these virus infections in renal transplant patients. OBJECTIVES To study the presence of KIPyV and WUPyV in upper respiratory, plasma and urine samples from renal transplant patients. To analyse clinical and personal data. STUDY DESIGN 532 respiratory, 503 plasma and 464 urine samples were collected from 77 renal transplant patients. KIPyV and WUPyV were detected by nested and quantitative real-time PCR. Patient and clinical data from medical records were analyzed. RESULTS KIPyV was detected in respiratory, plasma and urine samples from 14.3%, 3.9% and 4.1% of renal transplant patients. WUPyV was found in respiratory and plasma specimens from 9.1% and 5.3% of the patients. Significant association was revealed between the detection of KIPyV and WUPyV and the time of samples collection and the age of the patients. KIPyV was presented in respiratory and plasma sample at the same time. KIPyV was detected in plasma samples from two patients and in urine samples of three other patients providing also KIPyV positive respiratory samples at the same time. No clinical consequences of KIPyV or WUPyV infection were found. CONCLUSION Although no clinical consequences of KIPyV and WUPyV infections were found in renal transplant patients, it is suggested that renal transplantation might result in higher susceptibility or reactivation of these infection.
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Affiliation(s)
- Eszter Csoma
- Department of Medical Microbiology, University of Debrecen, Nagyerdei krt. 98., H-4032 Debrecen, Hungary.
| | - Beáta Mészáros
- Department of Medical Microbiology, University of Debrecen, Nagyerdei krt. 98., H-4032 Debrecen, Hungary
| | - László Asztalos
- First Department of Surgery, University of Debrecen, Nagyerdei krt. 98., H-4032 Debrecen, Hungary
| | - Lajos Gergely
- Department of Medical Microbiology, University of Debrecen, Nagyerdei krt. 98., H-4032 Debrecen, Hungary
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Nunes MC, Kuschner Z, Rabede Z, Cutland CL, Madimabe R, Kuwanda L, Klugman KP, Adrian PV, Madhi SA. Polyomaviruses-associated respiratory infections in HIV-infected and HIV-uninfected children. J Clin Virol 2014; 61:571-8. [PMID: 25467863 PMCID: PMC7173307 DOI: 10.1016/j.jcv.2014.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/15/2014] [Accepted: 10/20/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Two recently discovered polyomaviruses (PyV), WU and KI, have been identified in respiratory-tract specimens from children with acute respiratory infections, although there are limited data in HIV-infected children. OBJECTIVES To determine the prevalence and clinical manifestations of WUPyV and KIPyV-associated lower respiratory tract infections (LRTIs) hospitalization in HIV-infected and -uninfected children; and probe the role of pneumococcal co-infection. STUDY DESIGN Nasopharyngeal aspirates were collected from a cohort of 39,836 children randomized to receive 9-valent pneumococcal conjugate vaccine (PCV9) or placebo when hospitalized for LRTIs, and were screened by PCR for WUPyV, KIPyV and other respiratory viruses. RESULTS In placebo-recipients the prevalence of WUPyV was 6.3% (18/285) in HIV-infected and 13.9% (66/476) in HIV-uninfected children (p=0.002). In WUPyV-positive LRTIs HIV-infected children had lower oxygen saturation at admission and a higher case fatality rate (11.1% vs. 0%; p=0.04). KIPyV was identified in 10.2% (29/285) of HIV-infected and in 7.4% (35/476) of HIV-uninfected placebo-recipients with LRTIs (p=0.13). HIV-infected compared to HIV-uninfected children with KIPyV-positive LRTIs had lower oxygen saturation, higher respiratory rate and longer duration of hospitalization. Co-infections with other respiratory-viruses were detected in 65.5% of WUPyV-positive LRTIs and in 75.0% of KIPyV-positive LRTIs. Among HIV-uninfected children, there was a lower incidence of hospitalization for clinical pneumonia episodes in which KIPyV (80%; 95% CI: 41, 93) and WUPyV (49%; 95% CI: 9, 71) were identified among PCV9-recipients compared to placebo-recipients. CONCLUSIONS Polyomaviruses were commonly identified in HIV-infected and -uninfected children hospitalized for LRTIs, frequently in association with other viruses and may contribute to the pathogenesis of pneumococcal pneumonia.
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Affiliation(s)
- Marta C Nunes
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zachary Kuschner
- Stony Brook School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Zelda Rabede
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clare L Cutland
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Madimabe
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Locadiah Kuwanda
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Keith P Klugman
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Hubert Department of Global Health, Rollins School of Public Health and Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter V Adrian
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A Madhi
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; National Institute for Communicable Diseases: a division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa.
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Nunes MC, Kuschner Z, Rabede Z, Madimabe R, Van Niekerk N, Moloi J, Kuwanda L, Rossen JW, Klugman KP, Adrian PV, Madhi SA. Clinical epidemiology of bocavirus, rhinovirus, two polyomaviruses and four coronaviruses in HIV-infected and HIV-uninfected South African children. PLoS One 2014; 9:e86448. [PMID: 24498274 PMCID: PMC3911925 DOI: 10.1371/journal.pone.0086448] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 12/10/2013] [Indexed: 11/18/2022] Open
Abstract
Background Advances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV), human rhinovirus (hRV), polyomavirus-WU (WUPyV) and –KI (KIPyV) and human coronaviruses (CoV)-OC43, -NL63, -HKU1 and -229E among children hospitalized with lower respiratory tract infections (LRTI). Methods Multiplex real-time reverse-transcriptase polymerase chain reaction was undertaken on archived nasopharyngeal aspirates from HIV-infected and –uninfected children (<2 years age) hospitalized for LRTI, who had been previously investigated for respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus and influenza A/B. Results At least one of these viruses were identified in 274 (53.0%) of 517 and in 509 (54.0%) of 943 LRTI-episodes in HIV-infected and -uninfected children, respectively. Human rhinovirus was the most prevalent in HIV-infected (31.7%) and –uninfected children (32.0%), followed by CoV-OC43 (12.2%) and hBoV (9.5%) in HIV-infected; and by hBoV (13.3%) and WUPyV (11.9%) in HIV-uninfected children. Polyomavirus-KI (8.9% vs. 4.8%; p = 0.002) and CoV-OC43 (12.2% vs. 3.6%; p<0.001) were more prevalent in HIV-infected than –uninfected children. Combined with previously-tested viruses, respiratory viruses were identified in 60.9% of HIV-infected and 78.3% of HIV-uninfected children. The newly tested viruses were detected at high frequency in association with other respiratory viruses, including previously-investigated viruses (22.8% in HIV-infected and 28.5% in HIV–uninfected children). Conclusions We established that combined with previously-investigated viruses, at least one respiratory virus was identified in the majority of HIV-infected and HIV-uninfected children hospitalized for LRTI. The high frequency of viral co-infections illustrates the complexities in attributing causality to specific viruses in the aetiology of LRTI and may indicate a synergetic role of viral co-infections in the pathogenesis of childhood LRTI.
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Affiliation(s)
- Marta C. Nunes
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Zachary Kuschner
- Stony Brook School of Medicine, Stony Brook University, Stony Brook, New York, United States of America
| | - Zelda Rabede
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Madimabe
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nadia Van Niekerk
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jackie Moloi
- Molecular and Immunology Division, BioMérieux, Johannesburg, South Africa
| | - Locadiah Kuwanda
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - John W. Rossen
- Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Keith P. Klugman
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Hubert Department of Global Health, Rollins School of Public Health and Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Peter V. Adrian
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir A. Madhi
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Johannesburg, South Africa
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Institute for Communicable Diseases: a division of National Health Laboratory Service, Sandringham, South Africa
- * E-mail:
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Dierig A, Heron LG, Lambert SB, Yin JK, Leask J, Chow MYK, Sloots TP, Nissen MD, Ridda I, Booy R. Epidemiology of respiratory viral infections in children enrolled in a study of influenza vaccine effectiveness. Influenza Other Respir Viruses 2014; 8:293-301. [PMID: 24483149 PMCID: PMC4181477 DOI: 10.1111/irv.12229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Influenza-like illness (ILI) confers a high annual morbidity in young children. We report the epidemiology of ILIs in children who participated in an influenza vaccine effectiveness study during the 2010 Southern Hemisphere influenza season in Sydney, Australia. METHODS Children aged 0·5-3 years were prospectively recruited from child care centres (CCCs). We classified them as fully vaccinated, partially vaccinated and unvaccinated according to their receipt of unadjuvanted vaccines containing influenza A (H1N1)pdm09. For 13 weeks commencing 30 July 2010, parents reported when their children developed an ILI (fever ≥37·8°C/feverishness plus ≥1 respiratory symptom) and collected nose and/or throat swabs for multiplex respiratory virus polymerase chain reaction (PCR) testing. Health impacts were assessed by telephone interview at enrolment and two weeks after each ILI. RESULTS There were 124 ILIs reported in 105 of 381 enrolled children. Swabs were taken in 117 ILIs: 175 viruses were identified from 103 swabs. Adeno- and rhinoviruses were most frequently identified; 44% of swabs yielded multiple viruses. No virus was associated with more severe symptoms, although rhinovirus-related ILIs lasted longer. Nose swabs had a higher virus detection rate than throat swabs. Influenza-vaccinated children were 1·6 times (P = 0·001) more likely than unvaccinated children to have a non-influenza ILI. CONCLUSION Adeno- and rhinoviruses were the most common viruses causing ILI. Swabs taken by parents are an effective method for sample collection. Influenza-like illness was more common in children vaccinated against influenza in this observational study, but prior health-seeking behaviour may have contributed to this difference.
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Affiliation(s)
- Alexa Dierig
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW, Australia; University Children's Hospital both Basel, Basel, Switzerland
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Babakir-Mina M, Ciccozzi M, Perno CF, Ciotti M. The human polyomaviruses KI and WU: virological background and clinical implications. APMIS 2013; 121:746-54. [PMID: 23782405 DOI: 10.1111/apm.12091] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 01/09/2013] [Indexed: 01/25/2023]
Abstract
In 2007, two novel polyomaviruses KI and WU were uncovered in the respiratory secretions of children with acute respiratory symptoms. Seroepidemiological studies showed that infection by these viruses is widespread in the human population. Following these findings, different biological specimens and body compartments have been screened by real-time PCR in the attempt to establish a pathogenetic role for KI polyomavirus (KIPyV) and WU polyomavirus (WUPyV) in human diseases. Although both viruses have been found mainly in respiratory tract samples of immunocompromised patients, a clear causative link with the respiratory disease has not been established. Indeed, the lack of specific clinical or radiological findings, the frequent co-detection with other respiratory pathogens, the detection in subjects without signs or symptoms of respiratory disease, and the variability of the viral loads measured did not allow drawing a definitive conclusion. Prospective studies carried out on a large sample size including both immunocompromised and immunocompetent patients with and without respiratory symptoms are needed. Standardized quantitative real-time PCR methods, definition of a clear clinical cutoff value, timing in the collection of respiratory samples, are also crucial to understand the pathogenic role, if any, of KIPyV and WUPyV in human pathology.
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Ciotti M, Porrovecchio R, Perno CF. The novel KI, WU and MC polyomaviruses and human diseases. Future Virol 2013. [DOI: 10.2217/fvl.13.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
From 2007 to 2012, the Polyomaviridae family expanded with the discovery of several novel human polyomaviruses. Infection by polyomaviruses is widespread in the human population, but only immunocompromised patients are at risk for disease. Currently, four polyomaviruses have been specifically associated with human diseases: BK polyomavirus, JC polyomavirus, Merkel cell polyomavirus and trichodysplasia spinulosa-associated polyomavirus. The pathogenic potential of the other human polyomaviruses is unknown. This review focuses on the novel Karolinska Institute polyomavirus, Washington University polyomavirus and Merkel cell polyomavirus. Karolinska Institute polyomavirus and Washington University polyomavirus were uncovered in respiratory specimens of children with acute respiratory symptoms. Merkel cell polyomavirus was found in an aggressive skin tumor named Merkel cell carcinoma. The scientific literature concerning the three human polyomaviruses is summarized and discussed including seroepidemiology, detection methods (real-time PCR), histopathological findings and association with clinical manifestations.
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Affiliation(s)
- Marco Ciotti
- Laboratory of Molecular Virology, Foundation Polyclinic Tor Vergata, Viale Oxford 81-00133, Rome, Italy
| | - Rosa Porrovecchio
- Laboratory of Molecular Virology, Foundation Polyclinic Tor Vergata, Viale Oxford 81-00133, Rome, Italy
| | - Carlo Federico Perno
- Laboratory of Molecular Virology, Foundation Polyclinic Tor Vergata, Viale Oxford 81-00133, Rome, Italy
- Department of Experimental Medicine & Surgery, University of Rome Tor Vergata, Rome, Italy
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Goka E, Vallely P, Mutton K, Klapper P. Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza Other Respir Viruses 2012; 7:1079-87. [PMID: 23078095 PMCID: PMC4634299 DOI: 10.1111/irv.12020] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Please cite this paper as: Goka et al. (2013) Influenza A viruses dual and multiple infections with other respiratory viruses and risk of hospitalisation and mortality. Influenza and Other Respiratory Viruses 7(6), 1079–1087. Introduction Recent literature suggests that dual or multiple virus infections may affect disease severity. However, few studies have investigated the effect of co‐infection with influenza A viruses. Objectives To identify the association between influenza A and respiratory viruses co‐infections with disease outcome. Methodology Data for samples from North West England tested between January 2007 and June 2011 was analysed for patterns of co‐infection between influenza A viruses and eight respiratory viruses. Risk of hospitalisation to ICU or general ward in single versus co‐infections was assessed using logistic regression. Results Of the 25 596 samples analysed for respiratory viruses 40·7% (10 501) were positive for any virus. Co‐infections were detected in 4·7% (137/2879) of all patients with influenza A(H1N1)pdm09, and 7·3% (57/779) of those with other influenza A virus infections. Co‐infection between seasonal influenza A viruses and influenza B virus was associated with a significant increase in the risk of admission to ICU/death (OR: 22·0, 95% CI: 2·21–219·8, P = 0·008). Respiratory syncytial virus/influenza A (RSV/Flu A) co‐infection also increased this risk but was not statistically significant. For influenza A(H1N1)pdm09, RSV and AdV co‐infection increased risk of hospitalisation to general ward whereas Flu B increased risk of admission to ICU, but none of these were statistically significant. Conclusion Co‐infection is a significant predictor of disease outcome; combined treatment, introduction of an integrated vaccine for all respiratory viruses and development of multi‐target rapid diagnostic tests is recommended. Integration of respiratory viruses’ co‐infections into public health reports could also contribute to the accumulation of evidence.
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Affiliation(s)
- Edward Goka
- Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.Department of Clinical Virology, Central Manchester University Hospitals - NHS Foundation Trust, Manchester, UK
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Abstract
Lower respiratory tract infections (LRTIs) are a global burden to public health and are frequently caused by respiratory viruses. Advances in molecular diagnostic techniques have allowed the identification of previously undetected viral pathogens and have improved our understanding of respiratory virus infections. Here we review the epidemiological and clinical characteristics of recently identified viruses including human metapneumovirus, human coronaviruses NL63 and HKU1, human rhinovirus C, bocavirus, WU and KI polyomaviruses, and parechovirus. The roles of these viruses in LRTIs in children and adults are discussed.
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Affiliation(s)
- Lili Ren
- MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 9# Dong Dan San Tiao, Dongcheng District, Beijing, 100730 People’s Republic of China
| | - Zichun Xiang
- MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 9# Dong Dan San Tiao, Dongcheng District, Beijing, 100730 People’s Republic of China
| | - Li Guo
- MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 9# Dong Dan San Tiao, Dongcheng District, Beijing, 100730 People’s Republic of China
| | - Jianwei Wang
- MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, 9# Dong Dan San Tiao, Dongcheng District, Beijing, 100730 People’s Republic of China
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Van Ghelue M, Khan MTH, Ehlers B, Moens U. Genome analysis of the new human polyomaviruses. Rev Med Virol 2012; 22:354-77. [PMID: 22461085 DOI: 10.1002/rmv.1711] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 01/31/2012] [Accepted: 02/08/2012] [Indexed: 11/09/2022]
Abstract
Polyomaviridae is a growing family of naked, double-stranded DNA viruses that infect birds and mammals. The last few years, several new members infecting birds or primates have been discovered, including seven human polyomaviruses: KI, WU, Merkel cell polyomavirus, HPyV6, HPyV7, trichodysplasia spinulosa-associated polyomavirus, and HPyV9. In addition, DNA and antibodies against the monkey lymphotropic polyomavirus have been detected in humans, indicating that this virus can also infect man. However, little is known about the route of infection, transmission, cell tropism, and, with the exception of Merkel cell polyomavirus and trichodysplasia spinulosa-associated polyomavirus, the pathogenicity of these viruses. This review compares the genomes of these emerging human polyomaviruses with previously known polyomaviruses detected in man, reports mutations in different isolates, and predicts structural and functional properties of their viral proteins.
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Affiliation(s)
- Marijke Van Ghelue
- Department of Medical Genetics, University Hospital Northern-Norway, Tromsø, Norway
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Venter M, Lassaunière R, Kresfelder TL, Westerberg Y, Visser A. Contribution of common and recently described respiratory viruses to annual hospitalizations in children in South Africa. J Med Virol 2011; 83:1458-68. [PMID: 21678450 PMCID: PMC7166348 DOI: 10.1002/jmv.22120] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The contribution of viruses to lower respiratory tract disease in sub‐Saharan Africa where human immunodeficiency virus may exacerbate respiratory infections is not well defined. No data exist on some of these viruses for Southern Africa. Comprehensive molecular screening may define the role of these viruses as single and co‐infections in a population with a high HIV‐AIDS burden. To address this, children less than 5 years of age with respiratory infections from 3 public sector hospitals, Pretoria South Africa were screened for 14 respiratory viruses, by PCR over 2 years. Healthy control children from the same region were included. Rhinovirus was identified in 33% of patients, RSV (30.1%), PIV‐3 (7.8%), hBoV (6.1%), adenovirus (5.7%), hMPV (4.8%), influenza A (3.4%), coronavirus NL63 (2.1%), and OC43 (1.8%). PIV‐1, PIV‐2, CoV‐229E, ‐HKU1, and influenza B occurred in <1.5% of patients. Most cases with adenovirus, influenza A, hMPV, hBoV, coronaviruses, and WU virus occurred as co‐infections while RSV, PIV‐3, and rhinovirus were identified most frequently as the only respiratory pathogen. Rhinovirus but not RSV or PIV‐3 was also frequently identified in healthy controls. A higher HIV sero‐prevalence was noticed in patients with co‐infections although co‐infections were not associated with more severe disease. RSV, hPMV, PIV‐3, and influenza viruses had defined seasons while rhinovirus, adenovirus, and coronavirus infections occurred year round in this temporal region of sub‐Saharan Africa. J. Med. Virol. 83:1458–1468, 2011. © 2011 Wiley‐Liss, Inc.
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Affiliation(s)
- Marietjie Venter
- Department of Medical Virology, University of Pretoria, South Africa.
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Rao S, Garcea RL, Robinson CC, Simões EA. WU and KI polyomavirus infections in pediatric hematology/oncology patients with acute respiratory tract illness. J Clin Virol 2011; 52:28-32. [PMID: 21705268 PMCID: PMC3816538 DOI: 10.1016/j.jcv.2011.05.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/13/2011] [Accepted: 05/23/2011] [Indexed: 11/24/2022]
Abstract
Background WU and KI polyomaviruses (PyV) were discovered in 2007 in respiratory tract samples in adults and children. Other polyomaviruses (BKPyV and JCPyV) have been associated with illness in immunocompromised patients, and some studies suggest a higher prevalence of WUPyV and KIPyV in this population. Objective To determine whether a higher prevalence or viral load for WUPyV and KIPyV exists in immunocompromised children compared with immunocompetent children. Study design We measured the prevalence and viral load of WU and KI PyV by quantitative real-time PCR of viral DNA in respiratory tract specimens from pediatric hematology/oncology patients and immunocompetent controls with acute respiratory illnesses. Results The prevalence of WUPyV in the immunocompromised population was 5/161 (3%) versus 14/295 (5%) in the control population (P = 0.5), and 9/161 (5.6%) versus 7/295 (2.3%) respectively for KIPyV (P = 0.13). The mean viral load (in copies per cell or mL of sample) for KIPyV, was higher in the immunocompromised group compared to the control group (P = 0.019), but was not statistically different for WUPyV. A higher prevalence was seen in the hematopoietic stem cell transplant recipients compared with other immunocompromised patients (6/26 versus 3/43, P = 0.054). Viral persistence was demonstrated only in 1/25 (4%) of sequential samples for KIPyV, and no persistence was seen for WUPyV. Conclusions A higher prevalence of WUPyV or KIPyV in the immunocompromised population compared with the immunocompetent group was not demonstrated. Higher viral loads for KIPyV in the immunocompromised group may suggest an increased pathogenic potential in this population.
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Affiliation(s)
- Suchitra Rao
- Department of Pediatrics, B158 The Children's Hospital and University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, CO 80045, United States
| | - Robert L. Garcea
- Department of Molecular, Cellular, and Developmental Biology, Porter Science Bldg. B249C, 347 UCB, University of Colorado Boulder, CO 80309-0347, United States
| | - Christine C. Robinson
- Department of Virology, B120, The Children's Hospital and University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, CO 80045, United States
| | - Eric A.F. Simões
- Department of Pediatrics, B055 The Children's Hospital and University of Colorado School of Medicine, 13123 E 16th Ave, Aurora, CO 80045, United States
- Corresponding author. Tel.: +1 720 777 6977; fax: +1 720 777 7295.
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Babakir-Mina M, Ciccozzi M, Farchi F, Bergallo M, Cavallo R, Adorno G, Perno CF, Ciotti M. KI and WU polyomaviruses and CD4+ cell counts in HIV-1-infected patients, Italy. Emerg Infect Dis 2010; 16:1482-5. [PMID: 20735940 PMCID: PMC3294973 DOI: 10.3201/eid1609.100211] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To investigate an association between KI and WU polyomavirus (KIPyV and WUPyV) infections and CD4+ cell counts, we tested HIV-1–positive patients and blood donors. No association was found between cell counts and virus infections in HIV-1–positive patients. Frequency of KIPyV infection was similar for both groups. WUPyV was more frequent in HIV-1–positive patients.
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Astegiano S, Bergallo M, Solidoro P, Terlizzi ME, Libertucci D, Baldi S, Cavallo R, Costa C. Prevalence and clinical impact of polyomaviruses KI and WU in lung transplant recipients. Transplant Proc 2010; 42:1275-8. [PMID: 20534279 DOI: 10.1016/j.transproceed.2010.03.107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The newly discovered polyomaviruses KI and WU (KIV and WUV) were isolated from secretions of patients with respiratory symptoms as well as in blood, spleen, lymphoid tissues, and stools, especially in immunocompromised conditions. The aim of this work was to evaluate the prevalence of KIV and WUV in bronchoalveolar lavage (BAL) from lung transplant recipients. We also examined potential correlations between these viruses and occurrences of pneumonia, acute respiratory insufficiency, or other acute respiratory conditions and acute rejection episodes. Discharge diagnosis was based on the International Classification of Diseases-Italian version 2002, based on the 9th-revision clinical modification. A rejection episode was diagnosed by transbronchial lung biopsy in accordance with the 2007 International Society for Heart and Lung Transplantation Working Formulation. Overall, we analyzed 53 BALs obtained from 24 transplant recipients. Positive polymerase chain reaction results were observed in 6 samples (11.3%) from 6 patients (25%), versus 7 samples (13.2%) from 7 patients (29.2%) for KIV and WUV, respectively. Regarding the diagnosis of pneumonia, the prevalence was 22.2% and 33.3% for KIV and WUV, respectively. In cases of acute respiratory insufficiency or other acute respiratory conditions, 2 out of 9 samples were positive for KIV (22.2%) and 4 out of 9 for WUV (44.4%). An Acute rejection episode (ARE) was diagnosed in 7 instances among 6 lung transplant patients: The corresponding BAL specimens showed positive results for KIV in 3 out of 7 (42.8%) cases with ARE vs 3 out of 46 (6.5%) without an ARE (P < .05), and for WUV in 3 out of 7 (42.8%) vs 4 out of 46 (8.7%) (P < .05), respectively. Although the small number of specimens limits the statistical analysis, our results showed a higher prevalence of WUV compared with KIV. The compromised pulmonary environment in the lung allograft may cause reactivation of these viruses. Their roles in this context need to be further evaluated.
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Affiliation(s)
- S Astegiano
- Virology Unit, University Hospital S. Giovanni Battista, Turin, Italy
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Ciccozzi M, Babakir-Mina M, Lo Presti A, Farchi F, Zehender G, Ebranati E, Perno CF, Ciotti M. Genetic variability of the small t antigen of the novel KI, WU and MC polyomaviruses. Arch Virol 2010; 155:1433-8. [DOI: 10.1007/s00705-010-0725-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2010] [Accepted: 06/07/2010] [Indexed: 11/30/2022]
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Abstract
Exploration of the genetic diversity of WU polyomavirus (WUV) has been limited in terms of the specimen numbers and particularly the sizes of the genomic fragments analyzed. Using whole-genome sequencing of 48 WUV strains collected in four continents over a 5-year period and 16 publicly available whole-genome sequences, we identified three main WUV clades and five subtypes, provisionally termed Ia, Ib, Ic, II, IIIa, and IIIb. Overall nucleotide variation was low (0 to 1.2%). The discriminatory power of the previous VP2 fragment typing method was found to be limited, and a new, larger genotyping region within the VP2/1 interface was proposed.
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Babakir-Mina M, Ciccozzi M, Trento E, Perno CF, Ciotti M. KI and WU polyomaviruses in patients infected with HIV-1, Italy. Emerg Infect Dis 2009; 15:1323-5. [PMID: 19751608 PMCID: PMC2815986 DOI: 10.3201/eid1508.090424] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Kleines M, Häusler M, Krüttgen A, Scheithauer S. WU Polyomavirus (WUPyV): A Recently Detected Virus Causing Respiratory Disease? Viruses 2009; 1:678-88. [PMID: 21994565 PMCID: PMC3185540 DOI: 10.3390/v1030678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 10/19/2009] [Accepted: 11/04/2009] [Indexed: 11/16/2022] Open
Abstract
The WU polyomavirus (WUPyV) is a novel member of the family Polyomaviridae recently detected in respiratory tract specimens by shotgun sequencing. Intriguingly, viral genome has been detected in 0.4% to 11.5% of respiratory tract specimens from children with respiratory disease. The levels of co-infection with established respiratory viruses were in the range between 30.8% and 91.7%. Moreover, some studies report detection of WUPyV in stool or serum. So far, WUPyV infections can not be distinguished from other viral infections by means of clinical symptoms. Respiratory tract disease like pneumonia or bronchitis is frequently observed in patients harbouring WUPyV. Detection of viremia suggests systemic infections. However, the available data do not prove WUPyV to be a human pathogen. Further investigations are necessary.
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Affiliation(s)
- Michael Kleines
- Division of Virology, Department of Medical Microbiology, University Hospital Aachen, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +49 241 808 8573; Fax: +49 241 808 2483
| | - Martin Häusler
- Deparment of Pediatrics, University Hospital Aachen, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany; E-Mail:
| | - Alexander Krüttgen
- Division of Virology, Department of Medical Microbiology, University Hospital Aachen, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany; E-Mail:
| | - Simone Scheithauer
- Department of Infection Control and Infectious Diseases, University Hospital Aachen, RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany; E-Mail:
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Barzon L, Squarzon L, Militello V, Trevisan M, Palù G. Human KI and WU polyomavirus infection in immunocompromised subjects. J Clin Virol 2009; 45:370. [DOI: 10.1016/j.jcv.2009.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 05/15/2009] [Indexed: 11/16/2022]
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