Novel and classical human astroviruses in stool and cerebrospinal fluid: comprehensive screening in a tertiary care hospital, Switzerland

Figures & data

Figure 1 Study flowchart using eight rRT-PCRs to detect human astroviruses in stool and cerebrospinal (CSF) samples sent for viral screening in the laboratory of virology, University Hospitals of Geneva, 2015–2016.

Figure 2 Positive human astroviruses in stool samples. Top: Pie chart showing the prevalence and composition of classical and novel astroviruses among HAstV-positive patients. Bottom: histogram of the temporal distribution of cases. human astrovirus, HAstV.

Table 2 HAstV-positive stool samples: overall and stratified (classical and novel) HAstV patient characteristics

	All HAstVn=20	Classical HAstVn=10	Novel HAstVn=10	P value^a
Patient characteristics
Male sex – no. (%)	9 (45)	4 (40)	5 (50)
Age of pediatric and adult patients (yo)				0.3258
Median (range)	3.3 (0.06–53.0)	3.8 (0.5–53.0)	2.8 (0.06–51.0)
Mean±sd	12.2±18.6	14.0±19.6	10.4±18.4
Pediatric patients, no. (%)	15 (75)	7 (70)	8 (80)	1.000
Age of pediatric patients, months				0.3545
Median (range)	16.7 (0.8–57.7)	16.7 (6.4–57.7)	19.2 (0.8–50.0)
Mean±sd	24.4±20.1	27.3±21.6	21.8±19.8
Immunocompromised – no. (%)	9 (45)	5 (50)	4 (40)	1.000
Fever – no. (%)	7 (36.8)^b	4 (44.4)^c	3 (30)
With respiratory symptoms – no. (%)	8 (42.1)^b	1 (11.1)^c	7 (70)	0.020
Time interval between respiratory symptoms and HAstV detection (days)
Median (range)	11.5 (1–20)	7	13 (1–20)
Mean±sd	11.5±5.9	7	12.1±6.0
Time interval between transplantation and HAstV detection (days)
Median (range)	617 (6–1139)	617 (6–1139)	626.5 (142–1126)
Mean±sd	598.1±399.9	572.4±428.3	630.3±423.6
HAstV
Viral load (RNA copies/mL of resuspended stool)				0.0007
Median (range)	4.1 × E6 (3.4 × E2–6.0 × E11)	1.4 × E10 (2.1 × E5–6.0 × E11)	3.5 × E3 (3.4 × E2–3.3 × E9)
Mean±sd	3.9 × E10±1.3E × 11	7.7 × E10±1.9 × E11	3.3 × E8±1.0 × E9

Abbreviations: human astrovirus, HAstV; standard deviation, sd; years old, yo.

a P-values are for the comparison between the classical and novel HAstV-positive stool sample groups.

b Percentage calculated based on 19 patients (1 missing data, Table 1).

c Percentage calculated based on 9 patients (1 missing data, Table 1).

Figure 3 Classical and novel human astrovirus viral load in stool samples. The horizontal lines denote median log values. ***P<0.001. human astrovirus, HAstV.

Table 1 Clinical cases of classical and novel HAstV detection in stool samples

Patient characteristics					HAstV characteristics		Enteric virus stool screening	Clinical manifestations
Patient	Sex	Age	Immunodeficiency, etiology	Time between transplantation and HAstV detection	HAstV detected	Viral load (RNA copies/mL of resuspended stool)	Virus specie	Fever	Digestive symptoms, time between symptoms and HAstV detection	Type of digestive symptoms	Respiratory symptoms, time between symptoms and HAstV detection	Type of respiratory symptoms
1	M	3.1 years	No		HAstV-MLB1	5.5 × E4	Neg.	No	Yes, 2 days	Vomiting, diarrhea	Yes, 15 days	Cough
2	F	3.4 years	No		HAstV-MLB1	6.1 × E3	Neg.	Yes	Yes, 4 days	Diarrhea, abdominal pain	No
3	F	51.0 years	Yes, liver transplant recipient	26.4 months	HAstV-MLB1	3.3 × E2	Rotavirus	No	Yes, 1 day	Vomiting, diarrhea, abdominal pain	Yes, 1 day	Cough
4	M	4.2 years	Yes, liver transplant recipient	37.5 months	HAstV-MLB2	7.1 × E2	Neg.	No	Yes, 1 day	Diarrhea	Yes, 13 days	Cough, rhinorrhea
5	F	9.8 months	No		HAstV-MLB2	2.9 × E6	Neg.	No	Yes, 14 days	Diarrhea	Yes	Cough
6	M	2.4 years	Yes, liver transplant recipient	15.4 months	HAstV-MLB2	7.2 × E3	Neg.	No	Yes, 21 days	Diarrhea	Yes, 10 days	Odynophagia
7	M	38.2 years	Yes, allogeneic stem cell transplant recipient	4.7 months	HAstV-MLB2	3.3 × E9	Neg.	No	Yes, 3 days	Vomiting	No
8	F	1.4 months	No		HAstV-VA2	4.8 × E2	Neg.	Yes	Yes, 4 days	Diarrhea	Yes, 10 days	Rhinorrhea
9	F	23 days	No		HAstV-VA2	8.4 × E2	Enterovirus	Yes	Yes, 2 days	Diarrhea	No
10	M	5.1 months	No		HAstV-VA2	3.4 × E2	Neg.	No	Yes, 1 day	Diarrhea	Yes, 16 days	Cough, rhinorrhea
11	F	9.6 months	Yes, liver transplant recipient	6 days	Classical HAstV undet.	2.3 × E7	Neg.	Yes	Yes, 1 day	Diarrhea	No
12	M	4.2 years	No		Classical HAstV-8	2.0 × E10	Enterovirus	Yes	Yes, 2 days	Diarrhea	No
13	M	4.8 years	Yes, kidney transplant recipient	37.9 months	Classical HAstV undet.	2.1 × E5	Neg.	No	Yes, 4 days	Diarrhea	Yes, 7 days	Cough
14	M	1.4 years	No		Classical HAstV-1	2.4 × E10	Neg.	No	Yes, >30 days	Diarrhea	No
15	F	9.9 months	No		Classical HAstV-2	1.0 × E11	Neg.	No	Yes, 1 day	Vomiting, diarrhea	No
16	F	6.4 months	No		Classical HAstV-1	5.3 × E6	Neg.	Yes	Yes, 14 days	Vomiting, diarrhea	No
17	F	3.4 years	Yes, liver transplant recipient	20.6 months	Classical HAstV-4	1.6 × E9	Neg.	Yes	Yes, 2 days	Vomiting, diarrohea	No
18	M	40.2 years	Yes, allogeneic stem cell transplant recipient	25.4 months	Classical HAstV-1	7.5 × E9	Neg.	No	Yes, 5 days	Diarrhea	No
19	F	30.4 years	No		Classical HAstV-3	2.0 × E10	Neg.	No	Yes, 1 day	Vomiting, diarrhea	No
20	F	53.0 years	Yes, allogeneic stem cell transplant recipient	11.3 months	Classical HAstV-5	6.0 × E11	Neg.	NA	NA	NA	NA	NA

Abbreviations: human astrovirus, HAstV; not available, NA; negative, neg; undetermined, undet.