Insertions and deletions in the hypervariable region of the hepatitis E virus genome in individuals with acute and chronic infection

BACKGROUND AND AIMS

Hepatitis E virus is a major cause of acute hepatitis worldwide and can progress to chronicity in immunocompromised individuals. Various virus-host recombination events have been reported in the hypervariable region of the hepatitis E virus genome, but the patterns of assembly and selection remain unclear.

METHODS

To gain further insight into viral evolution, we assessed the presence of low abundance variants in 16 samples from individuals with acute or chronic infection using a targeted next-generation sequencing approach.

RESULTS

In seven samples, different variants with insertions and/or deletions were identified. Among them, eight insertions originating either from human genes or from the hepatitis E virus genome. Five different deletions could be identified. The amino acid composition of sequences with insertions showed a higher frequency of lysine and a lower abundance of proline, and additionally acetylation and ubiquitination sites were more frequent than in hepatitis E virus wild-type sequences.

CONCLUSIONS

These findings suggest that the nucleotide composition of insertions and sites for post-translational modification may contribute to recombination events. Although the impact of low-level hepatitis E virus variants is uncertain, our results highlight the importance of a highly sensitive next-generation sequencing approach to capture the full diversity of hypervariable region.

[Meningitis due to Capnocytophaga canimorsus with misleading initial digestive symptom]

We set out a case of Capnocytophaga canimorsus septicemia complicated by a meningitis in a chronic alcoholic male pensioner. The Capnocytophaga canimorsus bacterium contaminated the patient after his dog licked little varicose wounds. Initial symptoms led to a digestive infectious syndrome. Capnocytophaga canimorsus grows more slowly than usual bacteria and appeals to a bacteriological deductive reflection which is provided in this article for its identification in a general hospital. In order not to lose time with that infection which can be lethal, we describe the patient's ground, clinical signs which can be expected and we propose a probabilistic antibiotic therapy while waiting for the laboratory diagnosis.