Prevalence and Phylogenetic Analysis of Human Bocaviruses 1-4 in Pediatric Patients with Various Infectious Diseases

Abstract

ObjectivesViral infections caused by human bocaviruses 1–4 (HBoV1-4) are more complicated than previously believed. A retrospective, large-scale study was undertaken to explore the prevalence of HBoV1-4 in pediatric patients with various infectious diseases and delineate their phylogenetic characteristics.MethodsClinical samples from four specimen types, including 4,941 respiratory, 2,239 cerebrospinal fluid (CSF), 2,619 serum, and 1,121 fecal specimens, collected from pediatric patients with various infectious diseases were screened for HBoV1-4. A 690-nt fragment in each specimen was then amplified and sequenced for phylogenetic analysis. Clinical characteristics of HBoV-positive patients with different specimen types available were evaluated.ResultsApproximately 1.2% of patients were confirmed as HBoV-positive, with the highest positive rate in patients with gastrointestinal infection (2.2%), followed by respiratory (1.65%), central nervous system (0.8%), and hematological infections (0.2%). A single genetic lineage of HBoV1 circulated among children over the 8-year period, while a new cluster of HBoV2, via intra-genotype recombination between HBoV2A and HBoV2B, was prevalent. Some patients had HBoV1-positive respiratory and serum specimens or fecal specimens. Several cases became HBoV1-positive following the appearance of respiratory infection, while several cases were positive for HBoV2 only in CSF and serum specimens, rather than respiratory specimens.ConclusionsA single genetic lineage of HBoV1 is speculated as a viral pathogen of respiratory infection and causes both comorbid infection and acute gastroenteritis. Additionally, a new cluster of HBoV2 is prevalent in China, which may infect the host through sites other than the respiratory tract.

Human bocavirus infections and co-infections with respiratory syncytial virus and Rotavirus in children with acute respiratory or gastrointestinal disease

“…In major reports, HBoV is the most common infectious cause and after major viruses can result in acute respiratory infection in children under 3 years old [4,11,12]. The major reports, one of these reports is Calvo et al's study, in single infections and dual infections of HBoV state that HBoV was detected in 9.9% as a distinctive pathogen and 75% as co-infections with other viral agents [13].…”

Risk of acute gastroenteritis associated with human bocavirus infection in children: A systematic review and meta-analysis

“…In 2009–2010, three additional HBoV genotypes (HBoV2–4) were reported [ 7 – 13 ], inspiring interest in the role of HBoVs in children. A growing number of studies have subsequently shown that HBoV is frequently detected in the feces of children with acute gastroenteritis [ 14 – 16 ]. Some case-control studies reported that HBoV is just a bystander in acute gastroenteritis, but that finding disagrees with the results of other studies on this topic [ 17 ].…”