{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:45:51Z","timestamp":1791477951029,"version":"4.3.4"},"reference-count":25,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Hepatitis E virus (HEV) infection can lead to a variety of neurological disorders. While HEV RNA is known to be present in the central nervous system, HEV quasispecies in serum and cerebrospinal fluid (CSF) have rarely been explored. We studied the virus\u2019 quasispecies in the blood and the CSF of five patients at the onset of their neurological symptoms. The samples of three patients suffering from meningitis, neuralgic amyotrophy and acute inflammatory polyradiculoneuropathy were taken at the acute phase of the HEV infection. The samples from the other two patients were taken during the chronic phase (5 years after HEV diagnosis) when they presented with clinical signs of encephalitis. We sequenced at least 20 randomly polyproline regions of the selected virus clones. Phylogenetic analysis of the virus variants in the blood and the CSF revealed no virus compartmentalization for the three acute-phase patients but there was clear evidence of HEV quasispecies compartmentalization in the CSF of the two patients during chronic infection. In conclusion, prolonged infection in the immunocompromised condition can lead to independent virus replication in the liver and the tissues, producing viruses in CSF.<\/jats:p>","DOI":"10.3390\/vaccines9101205","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T22:07:04Z","timestamp":1634767624000},"page":"1205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Hepatitis E Virus Quasispecies in Cerebrospinal Fluid with Neurological Manifestations"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1753-1065","authenticated-orcid":false,"given":"Florence","family":"Abravanel","sequence":"first","affiliation":[{"name":"INSERM, Insitut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITY), INSERM URN1291-CNRS UMR 5051, Universit\u00e9 Toulouse III, F-31300 Toulouse, France"},{"name":"CHU Toulouse, H\u00f4pital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Nicot","sequence":"additional","affiliation":[{"name":"CHU Toulouse, H\u00f4pital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Lhomme","sequence":"additional","affiliation":[{"name":"INSERM, Insitut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITY), INSERM URN1291-CNRS UMR 5051, Universit\u00e9 Toulouse III, F-31300 Toulouse, France"},{"name":"CHU Toulouse, H\u00f4pital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cazabat","sequence":"additional","affiliation":[{"name":"INSERM, Insitut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITY), INSERM URN1291-CNRS UMR 5051, Universit\u00e9 Toulouse III, F-31300 Toulouse, France"},{"name":"CHU Toulouse, H\u00f4pital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Drumel","sequence":"additional","affiliation":[{"name":"CHU Nantes, Laboratoire de Virologie, CEDEX 1, F-44093 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Velay","sequence":"additional","affiliation":[{"name":"CHU Strasbourg, Laboratoire de Virologie, INSERM, IRM UMR 1109, F-67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Latour","sequence":"additional","affiliation":[{"name":"CHU Toulouse, H\u00f4pital Purpan, Laboratoire de Virologie, National Reference Center for Hepatitis E, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Belliere","sequence":"additional","affiliation":[{"name":"CHU Toulouse, H\u00f4pital Rangueil, D\u00e9partement de N\u00e9phrologie, Dialyse et Transplantation Multiorgane, F-31300 Toulouse, France"},{"name":"INSERM, U1048, Institut des Maladies M\u00e9taboliques et Cardiovasculaires, Rangueil, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Cintas","sequence":"additional","affiliation":[{"name":"CHU Toulouse, H\u00f4pital Purpan, D\u00e9partement de Neurologie, F-31300 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1930-8964","authenticated-orcid":false,"given":"Nassim","family":"Kamar","sequence":"additional","affiliation":[{"name":"INSERM, Insitut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITY), INSERM URN1291-CNRS UMR 5051, Universit\u00e9 Toulouse III, 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