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      New option: targeting RNase J and RNase HI in the fight against multi-drug-resistant tuberculosis

      editorial
      , MSc a , b , , , MSc a
      Annals of Medicine and Surgery
      Lippincott Williams & Wilkins

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              Insertions and Duplications in the Polyproline Region of the Hepatitis E Virus

              Recombinant strains of hepatitis E virus (HEV) with insertions of human genomic fragments or HEV sequence duplications in the sequence encoding the polyproline region (PPR) were previously described in chronically infected patients. Such genomic rearrangements confer a replicative advantage in vitro but little is known about their frequency, location, or origin. As the sequences of only a few virus genomes are available, we analyzed the complete genomes of 114 HEV genotype 3 strains from immunocompromised (n = 85) and immunocompetent (n = 29) patients using the single molecular real-time sequencing method to determine the frequency, location, and origin of inserted genomic fragments, plus the proportions of variants with genomic rearrangements in each virus quasispecies. We also examined the amino acid compositions and post-translational modifications conferred by these rearrangements by comparing them to sequences without human gene insertions or HEV gene duplications. We found genomic rearrangements in 7/114 (6.1%) complete genome sequences (4 HEV-3f, 1 HEV-3e, 1 HEV-3 h, and 1 HEV-3chi-new), all from immunocompromised patients, and 3/7 were found at the acute phase of infection. Six of the seven patients harbored virus-host recombinant variants, including one patient with two different recombinant variants. We also detected three recombinant variants with genome duplications of the PPR or PPR + X domains in a single patient. All the genomic rearrangements (seven human fragment insertions of varying origins and three HEV genome duplications) occurred in the PPR. The sequences with genomic rearrangements had specific characteristics: increased net load (p < 0.001) and more ubiquitination (p < 0.001), phosphorylation (p < 0.001), and acetylation (p < 0.001) sites. The human fragment insertions and HEV genome duplications had slightly different characteristics. We believe this is the first description of HEV strains with genomic rearrangements in patients at the acute phase of infection; perhaps these strains are directly transmitted. Clearly, genomic rearrangements produce a greater net load with duplications and insertions having different features. Further studies are needed to clarify the mechanisms by which such modifications influence HEV replication.
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                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                MS9
                Annals of Medicine and Surgery
                Lippincott Williams & Wilkins (Hagerstown, MD )
                2049-0801
                May 2024
                04 March 2024
                : 86
                : 5
                : 2376-2378
                Affiliations
                [a ]Tribhuvan University, Trichandra Multiple Campus, Kirtipur, Nepal
                [b ]State University of New York, Upstate Medical University, Syracuse, NY
                Author notes
                [* ]Corresponding author. Address: Tribhuvan University, Trichandra Multiple Campus, Kirtipur, 44600 Nepal. Tel.: +977 984 909 9853. E-mail: khadka.priyatam@ 123456gmail.com (P. Khadka).
                Article
                AMSU-D-23-02709 00003
                10.1097/MS9.0000000000001859
                11060219
                38694338
                186d778f-e78e-4e84-8988-2824f07149de
                Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/

                History
                : 20 December 2023
                : 13 February 2024
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                Editorials
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