Abstract

During the past three decades there has been a notable increase in dengue disease severity in Venezuela. Nevertheless, the population structure of the viruses being transmitted in this country is not well understood. Here, we present a molecular epidemiological study on dengue viruses (DENV) circulating in Aragua State, Venezuela during 2006–2007. Twenty-one DENV full-length genomes representing all of the four serotypes were amplified and sequenced directly from the serum samples. Notably, only DENV-2 was associated with severe disease. Phylogenetic trees constructed using Bayesian methods indicated that only one genotype was circulating for each serotype. However, extensive viral genetic diversity was found in DENV isolated from the same area during the same period, indicating significant in situ evolution since the introduction of these genotypes. Collectively, the results suggest that the non-structural (NS) proteins may play an important role in DENV evolution, particularly NS1, NS2A and NS4B proteins. The phylogenetic data provide evidence to suggest that multiple introductions of DENV have occurred from the Latin American region into Venezuela and vice versa. The implications of the significant viral genetic diversity generated during hyperendemic transmission, particularly in NS protein are discussed and considered in the context of future development and use of human monoclonal antibodies as antivirals and tetravalent vaccines.

Highlights

  • dengue viruses (DENV) is a single-stranded, positive-sense RNA virus belonging to the genus Flavivirus, family Flaviviridae

  • The results presented here, including the four DENV serotypes, suggest the non-structural proteins could play an important role in DENV evolution, principally NS1, NS2A and NS4B

  • The results presented suggest that NS proteins may play an important role in DENV virus evolution, NS1, NS2A and NS4B proteins, experimental confirmation based on a reverse genetics system are required

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Summary

Introduction

DENV is a single-stranded, positive-sense RNA virus belonging to the genus Flavivirus, family Flaviviridae. There are four antigenically distinct serotypes (DENV-1 to -4), all of which can cause illness. Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. While most patients recover following a self-limiting non-severe clinical course, a small proportion progress to severe disease, mostly characterised by plasma leakage with or without haemorrhage (WHO/TDR, 2009). In many tropical and subtropical countries DENV virus constitutes a major public health problem. During the past 30 years or so, in the Americas, dengue disease has increased dramatically. Over 4.5 million cases were reported during 2000–2007, compared

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