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. 2018 Aug 24;218(7):1045-1053.
doi: 10.1093/infdis/jiy256.

Molecular Characterization of Respiratory Syncytial Virus in Children With Repeated Infections With Subgroup B in the Philippines

Michiko Okamoto  1 , Clyde P Dapat  1 , Ann Marie D Sandagon  2 , Leilanie P Batangan-Nacion  3 , Irene C Lirio  3 , Raita Tamaki  1 , Mayuko Saito  1 , Mariko Saito-Obata  1   2 , Socorro P Lupisan  3 , Hitoshi Oshitani  1
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Molecular Characterization of Respiratory Syncytial Virus in Children With Repeated Infections With Subgroup B in the Philippines

Michiko Okamoto et al. J Infect Dis. .

Abstract

Background: Human respiratory syncytial virus (RSV) is the leading cause of severe acute respiratory infection in infants and young children, which is characterized by repeated infections. However, the role of amino acid substitutions in repeated infections remains unclear. Hence, this study aimed to elucidate the genetic characteristics of RSV in children with repeated infections using molecular analyses of F and G genes.

Methods: We conducted a cohort study of children younger than 5 years in the Philippines. We collected nasopharyngeal swabs from children with acute respiratory symptoms and compared F and G sequences between initial and subsequent RSV infections.

Results: We examined 1802 children from May 2014 to January 2016 and collected 3471 samples. Repeated infections were observed in 25 children, including 4 with homologous RSV-B reinfections. Viruses from the 4 pairs of homologous reinfections had amino acid substitutions in the G protein mostly at O-glycosylation sites, whereas changes in the F protein were identified at antigenic sites V (L173S) and θ (Q209K), considered essential epitopes for the prefusion conformation of the F protein.

Conclusions: Amino acid substitutions in G and F proteins of RSV-B might have led to antigenic changes, potentially contributing to homologous reinfections observed in this study.

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Figures

Figure 1.
Figure 1.
The monthly distribution of respiratory syncytial virus (RSV) in Caibiran and Kawayan in Biliran Province in the Philippines. Blue, ON1 (RSV-A) viruses; orange, BA9 (RSV-B) viruses; gray, viruses with undetermined subgroups.
Figure 2.
Figure 2.
Phylogenetic trees of complete sequences of the G gene (A) and F gene (B) of respiratory syncytial virus-B (RSV-B) from children with homologous reinfections and representative strains detected in the Philippines in 2014 and 2015. RSV-B sequences from children with repeated infections are indicated by a solid circle in red (child 1), blue (child 2), green (child 3), and black (child 4).
Figure 3.
Figure 3.
The monthly distribution of respiratory syncytial virus-B (RSV-B) with characteristic amino acid substitutions at position 254 in the G protein. Samples were collected in Caibiran (A) and Kawayan (B). Blue, ATI viruses with I254; red, TRT viruses with T254; gray, viruses with undetermined genotypes.
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