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Co-Circulation and Mixed Infections of Classic and Melbourne Human Astroviruses Among Pediatric Acute Gastroenteritis

Hiroshi Ushijima1, Yuko Onda-Shimizu1, Tomohiro Kotaki2

  • 1Department of Pathology and Microbiology, Division of Microbiology, Nihon University School of Medicine, Tokyo, Japan.

Journal of Medical Virology
|June 8, 2026
PubMed

Insights

Mixed infections of classic and Melbourne human astrovirus (HAstV) genotypes were detected in Japan. Conventional RT-PCR showed higher sensitivity than real-time RT-PCR for identifying these mixed HAstV infections.

Area of Science:

  • Virology
  • Molecular Epidemiology
  • Infectious Diseases

Background:

  • Simultaneous infection with multiple viral genotypes is common, particularly during outbreaks.
  • Human astrovirus (HAstV) and Melbourne (MLB) HAstV are significant causes of gastroenteritis.

Purpose of the Study:

  • To investigate mixed infections of classic HAstV and MLB HAstV in Japan from July 2018 to June 2024.
  • To compare the sensitivity of conventional RT-PCR and real-time RT-PCR for detecting mixed HAstV infections.

Main Methods:

  • Analysis of 2270 patient samples using conventional RT-PCR and real-time RT-PCR.
  • Screening, genotyping, and sequencing of the RNA-dependent RNA polymerase and capsid regions.
  • Semi-quantitative analysis of viral load in mixed infections.

Main Results:

  • HAstV was detected in 8.1% of patients; mixed HAstV infections were confirmed in 0.48% by conventional RT-PCR.
  • Most mixed infections (10/11) occurred during HAstV outbreaks in 2021-2022.
  • Conventional RT-PCR identified MLB1/HAstV1 and MLB2/HAstV1 combinations, showing higher sensitivity than real-time RT-PCR (0.13% detection rate).

Conclusions:

  • Mixed infections with distinct HAstV genotypes, including classic and MLB clades, do occur.
  • Conventional RT-PCR is more sensitive for detecting mixed HAstV infections compared to real-time RT-PCR.
  • Consideration of mixed HAstV infections is crucial for clinical and epidemiological investigations, especially in complicated cases.
Keywords:
Melbourne astrovirusastrovirusclassic astrovirusmixed infectionmolecular epidemiology

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