Monitoring of hepatitis E virus in wastewater can identify clinically relevant variants

Hepatitis E virus (HEV) is prevalent worldwide and can lead to persistent infection causing severe morbidity. Further, antiviral treatment approaches can lead to the emergence of viral variants that may impede viral clearance. The frequency of these variants remains unknown in the human population as well as environment due to limited comprehensive data on HEV diversity. In this study, we investigated the HEV prevalence and diversity of circulating variants in environmental samples from North-Rhine Westphalia, Germany. HEV prevalence could be determined with 73% of samples tested positive for viral RNA. Using ultra-deep sequencing we were able to assess the overall diversity in these samples and identified the presence of clinically relevant variants associated with drug resistance. In summary, monitoring variants from environmental samples could provide valuable insights into estimating HEV prevalence and identifying circulating variants that can impact treatment outcome.戊型肝炎病毒（Hepatitis E virus, HEV）在全球范围内广泛流行，可引发持续性感染并导致严重发病症状。此外，抗病毒治疗方案可能促使病毒变异株出现，此类变异株或可阻碍病毒清除。由于当前关于戊型肝炎病毒多样性的综合研究数据较为匮乏，人类群体与环境中此类变异株的出现频率仍未明确。本研究针对德国北莱茵-威斯特伐利亚州的环境样本，对戊型肝炎病毒的流行情况及循环变异株的多样性展开了调查。经检测，73%的样本病毒RNA呈阳性，据此可确定戊型肝炎病毒的流行率。通过超深度测序技术，本研究得以评估上述样本的整体病毒多样性，并鉴定出与耐药性相关的临床相关变异株。综上，对环境样本中的病毒变异株进行监测，可为估算戊型肝炎病毒流行率、识别可影响治疗效果的循环变异株提供极具价值的参考依据。