2010-06-24Zeitschriftenartikel DOI: 10.1086/653939
Chronic norovirus infection after kidney transplantation: molecular evidence for immune-driven viral evolution.
Wüthrich, Rudolf P.
Müller, Nicolas J.
Background: Norovirus infection is the most common cause of acute self-limiting gastroenteritis. Only 3 cases of chronic norovirus infection in adult solid organ transplant recipients have been reported thus far. Methods: This case series describes 9 consecutive kidney allograft recipients with chronic norovirus infection with persistent virus shedding and intermittent diarrhea for a duration of 97–898 days. The follow-up includes clinical course, type of immunosuppression, and polymerase chain reaction for norovirus. Detailed molecular analyses of virus isolates from stool specimens over time were performed. Results: The intensity of immunosuppression correlated with the diarrheal symptoms but not with viral shedding. Molecular analysis of virus strains from each patient revealed infection with different variants of GII.4 strains in 7 of 9 patients. Another 2 patients were infected with either the GII.7 or GII.17 strain. No molecular evidence for nosocomial transmission in our outpatient clinic was found. Capsid sequence alignments from followup specimens of 4 patients showed accumulation of mutations over time, resulting in amino acid changes predominantly in the P2 and P1–2 region. Up to 25 amino acids mutations were accumulated over a 683-day period in the patient with an 898-day shedding history. Conclusion: Norovirus infection may persist in adult renal allograft recipients with or without clinical symptoms. No evidence for nosocomial transmission in adult renal allograft recipients was found in our study. Molecular analysis suggests continuous viral evolution in immunocompromised patients who are unable to clear this infection.
Dateien zu dieser Publikation
Anzeige der Publikationen mit ähnlichem Titel, Autor, Urheber und Thema.
2013-07-16ZeitschriftenartikelA Mouse Model for Human Norovirus Taube, Stefan; Kolawole, Abimbola O.; Höhne, Marina; Wilkinson, John E.; Handley, Scott A.; Perry, Jeffrey W.; Thackray, Larissa B.; Akkina, Ramesh; Wobus, Christiane E.Human noroviruses (HuNoVs) cause significant morbidity and mortality worldwide. However, despite substantial efforts, a small-animal model for HuNoV has not been described to date. Since "humanized" mice have been successfully ...
2006-04-10ZeitschriftenartikelDetection of Norovirus genogroup I and II by multiplex real-time RT- PCR using a 3'-minor groove binder-DNA probe Hoehne, Marina; Schreier, EckartBackground: Due to an increasing number of norovirus infections in the last years rapid, specific, and sensitive diagnostic tools are needed. Reverse transcriptase-polymerase chain reactions (RT-PCR) have become the methods ...
2013-03-21ZeitschriftenartikelEpidemiology of norovirus gastroenteritis in Germany 2001-2009: eight seasons of routine surveillance Bernard, Helen; Höhne, Marina; Niendorf, Sandra; Altmann, Doris; Stark, KlausWe analysed data on laboratory or epidemiologically confirmed cases (n = 856,539) and on outbreaks (n = 31,644) notified during week 31 (2001) to week 30 (2009), and performed molecular typing of specimens from 665 outbreaks. ...