Distinct patterns of within-host virus populations between two subgroups of human respiratory syncytial virus

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Abstract

Human respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection in young children globally, but little is known about within-host RSV diversity. Here, we characterised within-host RSV populations using deep-sequencing data from 319 nasopharyngeal swabs collected during 2017–2020. RSV-B had lower consensus diversity than RSV-A at the population level, while exhibiting greater within-host diversity. Two RSV-B consensus sequences had an amino acid alteration (K68N) in the fusion (F) protein, which has been associated with reduced susceptibility to nirsevimab (MEDI8897), a novel RSV monoclonal antibody under development. In addition, several minor variants were identified in the antigenic sites of the F protein, one of which may confer resistance to palivizumab, the only licensed RSV monoclonal antibody. The differences in within-host virus populations emphasise the importance of monitoring for vaccine efficacy and may help to explain the different prevalences of monoclonal antibody-escape mutants between the two subgroups.

Original languageEnglish
Article number5125
Pages (from-to)1-11
Number of pages11
JournalNature Communications
Volume12
Issue number1
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Aged
  • Antigenic Variation
  • Female
  • Genetic Variation
  • Humans
  • Infant
  • Male
  • Mutation, Missense
  • Respiratory Syncytial Virus Infections/immunology
  • Respiratory Syncytial Virus, Human/classification
  • Viral Proteins/genetics
  • Virus Replication

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