Biography
Biography: Hebah Al Khatib
Abstract
Background: The diversity of RNA viruses dictates their evolution in a particular host, community or environment. Here, we reported within- and between host pH1N1virus diversity at consensus and sub-consensus levels over a three-year period (2015-2017) and the implications of this diversity on disease severity.
Method: A total of 90 nasal samples positive for pH1N1 virus were deep sequenced using NGS technology and analysed to detected low-frequency variants (LFVs) and haplotypes.
Finidings: Parallel evolution of LFVs was seen in hemagglutinin and neuraminidase genes across three scales: among patients, across years and at global scale. Remarkably, investigating the emergence of LFVs at consensus level demonstrated that within host virus evolution recapitulates many evolutionary dynamics observed at the global scale. This was most obvious in HA gene, where 22% of LFVs emerged successfully at consensus level globally, compared to 7% in NA gene. Analysis of intra and inter host genetic diversity at HA haplotype level revealed the clustering of low-frequency haplotypes from early 2015 with dominant strains of 2016, indicating rapid haplotype evolution. In all years, haplotype clustering pattern was not always patient specific, strongly suggesting the transmission of haplotypes among patients infected during a specific flu season and parallel evolution of virus in independent hosts. Finally, factors such as patient age, haplotype diversity, and the existence of certain mutations in HA haplotypes should be considered when interpreting illness severity