Abstract
BackgroundRSV is a leading cause of lower respiratory tract infection in infants. Monitoring RSV glycoprotein sequences is critical for understanding RSV epidemiology and viral antigenicity in the effort to develop anti‐RSV prophylactics and therapeutics.ObjectivesThe objective is to characterize the circulating RSV strains collected from infants in South Africa during 2015‐2017.MethodsA subset of 150 RSV‐positive samples obtained in South Africa from HIV‐unexposed and HIV‐exposed‐uninfected infants from 2015 to 2017, were selected for high‐throughput next‐generation sequencing of the RSV F and G glycoprotein genes. The RSV G and F sequences were analyzed by a bioinformatic pipeline and compared to the USA samples from the same three‐year period.ResultsBoth RSV A and RSV B co‐circulated in South Africa during 2015‐2017, with a shift from RSV A (58%‐61% in 2015‐2016) to RSV B (69%) in 2017. RSV A ON1 and RSV B BA9 genotypes emerged as the most prevalent genotypes in 2017. Variations at the F protein antigenic sites were observed for both RSV A and B strains, with dominant changes (L172Q/S173L) at antigenic site V observed in RSV B strains. RSV A and B F protein sequences from South Africa were very similar to the USA isolates except for a higher rate of RSV A NA1 and RSV B BA10 genotypes in South Africa.ConclusionRSV G and F genes continue to evolve and exhibit both local and global circulation patterns in South Africa, supporting the need for continued national surveillance.
Highlights
Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory tract infection (LRTI) in children globally
It was estimated that in 2015, 33.1 million episodes of LRTI, 3.2 million hospitalizations, and as many as 118,200 deaths were attributable to RSV in children
Developing countries have a much higher incidence of severe RSV LRTI compared to developed countries, with approximately 91% of all RSV-associated hospitalizations and 99% of deaths occurring in developing countries.[2]
Summary
Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory tract infection (LRTI) in children globally. The two surface glycoproteins, the fusion (F) and the attachment (G) protein, are crucial for virus infectivity and pathogenesis, and are the major antigens to stimulate the production of neutralizing antibodies.[3,4,5] While the G protein is responsible for the attachment of the virus to the host epithelial cells, the F protein mediates viral entry by fusing viral and cellular membranes, leading to the subsequent release of viral RNA into the host cell cytoplasm.[6] RSV has two subtypes, A and B, which are further characterized into different genotypes, based on antigenic and genetic variability of the second hypervariable region (HVR2) of the G protein.[7] In contrast to the G protein, the F protein is well-conserved between the two RSV subtypes and among different genotypes. The RSV sequence data obtained from South Africa were further compared to RSV sequences obtained from the USA during the same period.[18]
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