Abravanel Florence, Nicot Florence, Lhomme Sébastien, Cazabat Michele, Drumel Thomas, Velay Aurélie, Latour Justine, Belliere Julie, Cintas Pascal, Kamar Nassim, Izopet Jacques
INSERM, Insitut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITY), INSERM URN1291-CNRS UMR 5051, Université Toulouse III, F-31300 Toulouse, France.
CHU Toulouse, Hôpital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France.
Vaccines (Basel). 2021 Oct 19;9(10):1205. doi: 10.3390/vaccines9101205.
Hepatitis E virus (HEV) infection can lead to a variety of neurological disorders. While HEV RNA is known to be present in the central nervous system, HEV quasispecies in serum and cerebrospinal fluid (CSF) have rarely been explored. We studied the virus' quasispecies in the blood and the CSF of five patients at the onset of their neurological symptoms. The samples of three patients suffering from meningitis, neuralgic amyotrophy and acute inflammatory polyradiculoneuropathy were taken at the acute phase of the HEV infection. The samples from the other two patients were taken during the chronic phase (5 years after HEV diagnosis) when they presented with clinical signs of encephalitis. We sequenced at least 20 randomly polyproline regions of the selected virus clones. Phylogenetic analysis of the virus variants in the blood and the CSF revealed no virus compartmentalization for the three acute-phase patients but there was clear evidence of HEV quasispecies compartmentalization in the CSF of the two patients during chronic infection. In conclusion, prolonged infection in the immunocompromised condition can lead to independent virus replication in the liver and the tissues, producing viruses in CSF.
戊型肝炎病毒（HEV）感染可导致多种神经紊乱。虽然已知HEV RNA存在于中枢神经系统中，但血清和脑脊液（CSF）中的HEV准种很少被研究。我们研究了五名患者在出现神经症状时血液和脑脊液中的病毒准种。三名患有脑膜炎、神经性肌萎缩和急性炎症性多发性神经根神经病的患者样本是在HEV感染急性期采集的。另外两名患者的样本是在慢性期（HEV诊断后5年）采集的，当时他们出现了脑炎的临床症状。我们对所选病毒克隆的至少20个随机多聚脯氨酸区域进行了测序。对血液和脑脊液中病毒变体的系统发育分析显示，三名急性期患者没有病毒分区现象，但在慢性感染期间，两名患者的脑脊液中有明确的HEV准种分区证据。总之，免疫功能低下状态下的长期感染可导致病毒在肝脏和组织中独立复制，在脑脊液中产生病毒。
