Abstract
Human bocavirus (HBoV) is an emerging virus and has been detected worldwide, especially in pediatric patients with respiratory and gastrointestinal infection. In this study, we describe HBoV prevalence, genotypes circulation and DNA shedding, in stool samples from children up to two years of age in Brazil. During 2016 and 2017, 886 acute gastroenteritis (AGE) stool samples from ten Brazilian states were analyzed by TaqMan®-based qPCR, to detect and quantify HBoV. Positive samples were genotyped by sequencing the VP1/2 overlap region, followed by phylogenetic analysis and co-infections were accessed by screening other gastroenteric viruses. HBoV was detected in 12.4% (n = 110) of samples, with viral load ranging from 1.6 × 102 to 1.2 × 109 genome copies per gram of stool. From these, co-infections were found in 79.1%, and a statistically lower HBoV viral load was found compared to viral loads of rotavirus, norovirus and adenovirus in double infected patients (p < 0.05). No significant differences were found between HBoV viral load in single or co-infections, age groups or genotypes. Phylogenetic analysis identified the circulation of HBoV-1 in 38%, HBoV-2 in 40% and HBoV-3 in 22%. Continuous HBoV monitoring is needed to clarify its role in diarrhea disease, especially in the absence of classic gastroenteric viruses.
Highlights
Acute gastroenteritis (AGE), a preventable disease, still figures as a leading cause of death in young children and contributes significantly to childhood morbidity, especially in low-income countries [1,2,3].Among the main viral agents associated with pediatric acute gastroenteritis (AGE), rotavirus A (RVA), norovirus and human adenovirus (HAdV) figure as the main etiological agents worldwide [3,4,5]
During the two-year period of this study (2016–2017), we analysed a total of 886 stool samples from symptomatic children aged ≤2 years
We found that in 20.9% of samples (n = 23), human bocavirus (HBoV) was detected as single infection, whilst 79.1% of samples (n = 87) were co-infected with one or more viral agent (RVA, HAdV, norovirus GI and GII, sapovirus and astrovirus) (Table 1)
Summary
Acute gastroenteritis (AGE), a preventable disease, still figures as a leading cause of death in young children and contributes significantly to childhood morbidity, especially in low-income countries [1,2,3]. Among the main viral agents associated with pediatric AGE, rotavirus A (RVA), norovirus and human adenovirus (HAdV) figure as the main etiological agents worldwide [3,4,5]. The etiology of a significant number of AGE cases (up to 40%) remains undermined, especially in developing countries [6,7]. A diagnostic gap as large as a third of all AGE specimens has been estimated [8], suggesting that less common viral agents could play a role in causing the disease.
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