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Evolution of poliovirus type I during 5.5 years of prolonged enteral replication in an immunodeficient patient
1Institut für Virologie, Medizinische Hochschule, Hannover, Germany.
Abstract:
Poliovirus type 1 was isolated from an immunodeficient patient 4 days after onset of paresis (IS1) and after 5.5 years of prolonged enteral virus replication (IS2). Antigenic characterization revealed that IS1 was Sabin 1-like, whereas IS2 reacted like poliovirus 1 Mahoney. Complete genomic sequencing demonstrated the phylogenetic relationship (94.9% identity) of IS1 and IS2, which differed from the most closely related Sabin 1 by 5.4 and 8.3%, respectively. Both isolates had revertant-like mutations at nucleotides 480 and 6203. Deduced amino acid sequences indicated significant changes between IS1 and IS2 at the neutralizing antigenic site 1. Prolonged enteral replication, evolution, and shedding of poliovirus by immunodeficient patients should be considered in the poliovirus eradication strategy.
Insights
Immunodeficient patients can shed poliovirus for years, with prolonged replication leading to viral evolution. This finding is crucial for global poliovirus eradication strategies.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Poliovirus shedding in immunodeficient patients can be prolonged.
- Understanding viral evolution in these cases is critical for eradication efforts.
Purpose of the Study:
- To characterize poliovirus isolates from an immunodeficient patient with prolonged replication.
- To investigate the genetic and antigenic changes in poliovirus during long-term shedding.
Main Methods:
- Isolation and antigenic characterization of poliovirus from patient samples.
- Complete genomic sequencing of poliovirus isolates.
- Phylogenetic analysis and comparison with reference strains.
Main Results:
- Two poliovirus type 1 isolates (IS1 and IS2) were obtained from an immunodeficient patient.
- IS1 was Sabin 1-like, while IS2 showed characteristics of poliovirus 1 Mahoney after 5.5 years of replication.
- Genomic sequencing revealed significant divergence between IS1 and IS2, with revertant-like mutations and changes in antigenic site 1.
Conclusions:
- Prolonged enteral poliovirus replication in immunodeficient individuals can lead to significant viral evolution.
- These evolving strains may pose a challenge to poliovirus eradication.
- Consideration of long-term viral shedding and evolution in immunodeficient patients is essential for global poliovirus eradication strategies.