{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:39:28Z","timestamp":1772138368806,"version":"3.50.1"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,5,3]],"date-time":"2019-05-03T00:00:00Z","timestamp":1556841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000867","name":"Commonwealth Scholarship Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_12014\/3"],"award-info":[{"award-number":["MC_UU_12014\/3"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["204870\/Z\/16\/Z"],"award-info":[{"award-number":["204870\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In developed countries, human cytomegalovirus (HCMV) is a major pathogen in congenitally infected and immunocompromised individuals, where multiple-strain infection appears linked to disease severity. The situation is less documented in developing countries. In Zambia, breast milk is a key route for transmitting HCMV and carries higher viral loads in human immunodeficiency virus (HIV)\u2013infected women. We investigated HCMV strain diversity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>High-throughput sequence datasets were generated from 28 HCMV-positive breast milk samples donated by 22 mothers (15 HIV-infected and 7 HIV-negative) at 4\u201316 weeks postpartum, then analyzed by genome assembly and novel motif-based genotyping in 12 hypervariable HCMV genes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 20 samples from 14 donors (13 HIV-infected and one HIV-negative) who yielded data meeting quality thresholds, 89 of the possible 109 genotypes were detected, and multiple-strain infections involving up to 5 strains per person were apparent in 9 HIV-infected women. Strain diversity was extensive among individuals but conserved compartmentally and longitudinally within them. Genotypic linkage was maintained within hypervariable UL73\/UL74 and RL12\/RL13\/UL1 loci for virus entry and immunomodulation, but not between genes more distant from each other.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Breast milk from HIV-infected women contains multiple HCMV strains of high genotypic complexity and thus constitutes a major source for transmitting viral diversity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiz209","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T15:10:29Z","timestamp":1556723429000},"page":"792-801","source":"Crossref","is-referenced-by-count":44,"title":["Multiple-Strain Infections of Human Cytomegalovirus With High Genomic Diversity Are Common in Breast Milk From Human Immunodeficiency Virus\u2013Infected Women in Zambia"],"prefix":"10.1093","volume":"220","author":[{"given":"Nicol\u00e1s M","family":"Su\u00e1rez","sequence":"first","affiliation":[{"name":"Medical Research Council\u2013University of Glasgow Centre for Virus Research, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunda G","family":"Musonda","sequence":"additional","affiliation":[{"name":"Pathogen Molecular Biology Department, London School of Hygiene and Tropical Medicine, United Kingdom"},{"name":"Virology Laboratory, University Teaching Hospital, Lusaka, Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Escriva","sequence":"additional","affiliation":[{"name":"Pathogen Molecular Biology Department, London School of Hygiene and Tropical Medicine, United Kingdom"},{"name":"Birkbeck College, University of London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Njenga","sequence":"additional","affiliation":[{"name":"Pathogen Molecular Biology Department, London School of Hygiene and Tropical Medicine, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Agbueze","sequence":"additional","affiliation":[{"name":"Pathogen Molecular Biology Department, London School of Hygiene and Tropical Medicine, United Kingdom"},{"name":"Birkbeck College, University of London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Camiolo","sequence":"additional","affiliation":[{"name":"Medical Research Council\u2013University of Glasgow Centre for Virus Research, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Davison","sequence":"additional","affiliation":[{"name":"Medical Research Council\u2013University of Glasgow Centre for Virus Research, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula A","family":"Gompels","sequence":"additional","affiliation":[{"name":"Pathogen Molecular Biology Department, London School of Hygiene and Tropical Medicine, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,5,3]]},"reference":[{"key":"2019121022401818000_CIT0001","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1093\/cid\/cir837","article-title":"Human cytomegalovirus infant infection adversely affects growth and development in maternally HIV-exposed and unexposed infants in Zambia","volume":"54","author":"Gompels","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2019121022401818000_CIT0002","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1001\/jamapediatrics.2014.1360","article-title":"Blood transfusion and breast milk transmission of cytomegalovirus in very low-birth-weight 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