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doi: 10.1056/NEJMc1301022.Norovirus gastroenteritis in immunocompromised patients
- PMID:23465122
- PMCID: PMC4793940
- DOI: 10.1056/NEJMc1301022
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Comment
Norovirus gastroenteritis in immunocompromised patients
Sarah Haessler et al. N Engl J Med..
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No potential conflict of interest relevant to this article was reported.
Figures
The RNA genome of the prototype norovirus strain, Norwalk virus (shown at thetop), is organized into three open reading frames (ORF1, ORF2, and ORF3) thatencode the designated nonstructural and structural proteins. Most diagnosticprimers used in reverse-transcriptase–polymerase-chain-reaction assaytarget conserved areas in the RNA-dependent RNA polymerase region(NS7POL). VP1, the major capsid protein (shown below), is furtherorganized into the N-terminal (N), shell (S), and protruding (P) domains definedby the indicated VP1 amino acid residues. The P2 region of the P domain (blue)is exposed on the surface of the capsid protein and is the site wherehisto–blood group antigens (HBGAs) (magenta) interact with the virion(dashed box).,
The bar graph shows the frequency distribution of VP1 norovirus variants,identified through next-generation sequencing, in an immunocompetent host and animmunocompromised host. Each unique variant is represented by a different color.Given the limited color palette, repeated colors represent distinct variants.Low-frequency variants, with an estimated frequency of occurrence below thedetection threshold (2%), are shown in gray. Only two variants weredetected in the immunocompetent host, and they remained stable throughout the 10days of infection. No predominant variant was observed in the immunocompromisedhost. Instead, numerous low-frequency variants coexisted, and their prevalencesvaried over the course of the infection. Adapted from Bull et al.
Comment on
- Norovirus gastroenteritis in immunocompromised patients.Bok K, Green KY.Bok K, et al.N Engl J Med. 2012 Nov 29;367(22):2126-32. doi: 10.1056/NEJMra1207742.N Engl J Med. 2012.PMID:23190223Free PMC article.Review.No abstract available.
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