Human pegivirus detected in a patient with severe encephalitis using a metagenomic pan-virus array

Fridholm, Helena; Sørensen, Line Østergaard; Rosenstierne, Maiken Worsøe; Nielsen, Henrik; Sellebjerg, Finn; Andersen, Åse Bengård; Fomsgaard, Anders

doi:10.1016/j.jcv.2016.01.013

Cited by 18 publications

(18 citation statements)

References 30 publications

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“…Furthermore, the association of HPgV with multiple sclerosis could not be established because the study was limited to a single case. In the third study, HPgV was detected in serum and CSF of a patient with a severe form of encephalitis of unclear origin ( 17 ). Of these 3 studies, none included comparison of serum- and CNS-derived virus.…”

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confidence: 99%

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Human Pegivirus in Patients with Encephalitis of Unclear Etiology, Poland

Bukowska-Ośko¹,

Perlejewski²,

Rydzanicz³

et al. 2018

Emerg. Infect. Dis.

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confidence: 99%

“…Three recent case reports described HPgV RNA in the human central nervous system (CNS), demonstrating that the virus can be present in the brain under certain circumstances ( 15 – 17 ). In the first study, viral sequences were detected postmortem in brain tissue from a patient with multiple sclerosis, not encephalitis ( 15 ).…”

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confidence: 99%

Human Pegivirus in Patients with Encephalitis of Unclear Etiology, Poland

Bukowska-Ośko¹,

Perlejewski²,

Rydzanicz³

et al. 2018

Emerg. Infect. Dis.

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“…Although it was reported that B19V shows lifelong persistence in the heart,33 its relevance to myocarditis in the present case was suggested because B19V DNA was detected from both serum and myocardium specimens.In RNA sequencing, a large number of HPgV sequence reads were detected from one patient (patient 16). HPgV was initially suspected to be a cause of chronic hepatitis; however, the pathogenicity of HPgV to human remains inconclusive, despite its capacity for persistent viremia 34,35. In addition, astrovirus, tobacco mosaic virus, and peanut stunt virus were detected in RNA sequencing, but viral reads were derived from the single location of each reference genome (data not shown).…”

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confidence: 99%

Identification of potential pathogenic viruses in patients with acute myocarditis using next‐generation sequencing

Takeuchi

Kawada

Horiba

et al. 2018

Journal of Medical Virology

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Myocarditis is an inflammatory disease of the myocardium and leads to cardiac dysfunction and heart failure. Although viral infections are considered to be the most common etiology of myocarditis, the identification of the causative virus is still challenging. Recently, next-generation sequencing (NGS) has been applied in the diagnosis of infectious diseases. The aim of the current study was to comprehensively analyze potential pathogenic microorganisms using NGS in the sera of patients with myocarditis. Twelve pediatric and five adult patients hospitalized for acute myocarditis were included. Serum samples in the acute phase were obtained and analyzed using NGS to detect pathogen-derived DNA and RNA. Viral sequence reads were detected in 7 (41%) of the 17 myocarditis patients by NGS. Among these patients, detection of Epstein-Barr virus, human parvovirus B19, torque teno virus, and respiratory syncytial virus reads by NGS was consistent with polymerase chain reaction or antigen test results in one patient each. A large number of human pegivirus reads were detected from one patient by RNA sequencing; however, its pathogenicity to human is unknown. Conversely, the number of detected virus-derived reads was small in most cases, and the pathophysiological role of these viruses remains to be clarified. No significant bacterial or fungal reads other than normal bacterial flora was detected. These data indicate that comprehensive detection of virus-derived DNA and RNA using NGS can be useful for the identification of potential pathogenic viruses in myocarditis.

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“…Human pegivirus has been detected in 1-45% of healthy blood donors worldwide [24]. Detection of this virus in CSF samples from patients with encephalitis through metagenomics sequencing brings questions related to its apparent pathogenicity versus coincidental detection from a leaky blood-brain barrier(BBB) [25]. A recent study used whole genome sequencing of pegivirus virions in samples from CSF and serum in patients with undiagnosed encephalitis [26] and demonstrated divergent sequences suggesting compartmentalisation and potential pathological replication in the CNS.…”

Section: Sequencingmentioning

confidence: 99%

Advances in molecular diagnostic testing for central nervous system infections

Houlihan

Bharucha

Breuer

2019

Current Opinion in Infectious Diseases

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Purpose of review Central nervous system (CNS) infections present an ongoing diagnostic challenge for clinicians, with an aetiological agent remaining unidentified in the majority of cases even in high income settings. This review summarises developments in a range of diagnostic methods published in the past 18 months. Recent findings Several commercial assays exist for the detection of viral, bacterial and fungal pathogens using single multiplex PCR. Multicentre validation of the Biofire FilmArray panel illustrated high sensitivity for bacterial and fungal pathogens, but poor results for Cryptococcus species detection. The development of microarray cards for bacterial CNS pathogens shows promise but requires further validation. Few developments have been made in proteomics and transcriptomics, contrasted with significant increase in the use of metagenomic (or unbiased) sequencing. Novel viruses causing CNS infection have been described using this technique but contamination, cost, expertise and turnaround time requirements remain restrictive. Finally, the development of Gene Xpert and Ultra have revolutionised TB meningitis diagnostics with newly released recommendations for their use from the World Health Organisation.

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Human pegivirus detected in a patient with severe encephalitis using a metagenomic pan-virus array

Cited by 18 publications

References 30 publications

Human Pegivirus in Patients with Encephalitis of Unclear Etiology, Poland

Human Pegivirus in Patients with Encephalitis of Unclear Etiology, Poland

Identification of potential pathogenic viruses in patients with acute myocarditis using next‐generation sequencing

Advances in molecular diagnostic testing for central nervous system infections

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