title: TT virus: a study of molecular epidemiology and transmission of genotypes 1, 2 and 3.
abstract: BACKGROUND
  TT virus (TTV) is a recently discovered virus, which is not related to any other known virus infecting humans.
  
  
  OBJECTIVE
  To investigate: (i) the world-wide distribution of the three major TTV genotypes; and (ii) the possible routes of viral transmission.
  
  
  METHODS
  (i) The phylogenetic distribution of 494 TTV isolates originating from 31 countries was analysed, using partial ORF1 sequences. (ii) Faeces samples (n=22) and saliva samples (n=72) from French individuals were tested for the presence of TTV DNA. (iii) Viral titres in paired serum and saliva samples were compared.
  
  
  RESULTS
  (i) Genotypes 1, 2 and 3 were distributed world-wide, with a high proportion of type 1 in Asia (71%) and no type 3 identified in Africa to date. In the USA, 77% of isolates were grouped in four clusters only (genetic distances <10%). This was also the case of 76% of French isolates, 76% of Japanese isolates, and 89% of Hong Kong isolates. (ii) TTV DNA was detected in 18% of faeces samples and 68% of saliva samples tested. (iii) Viral titre in saliva samples was 100-1000 times higher than that of the corresponding serum.
  
  
  CONCLUSIONS
  (i) The observed epidemiological distribution of TTV isolates is compatible with an ancient dissemination of viral ancestors belonging to the different genotypes and a slow genetic evolution in sedentary populations. (ii) Besides the possible transmission of TTV by the parental and oral-faecal routes, the high titre of TTV DNA observed in saliva raises the hypothesis of the viral transmission by saliva droplets. This route of transmission could explain the high degree of exposure to viral infection observed in the general population.
authors.affiliation: Unité des Virus Emergents, Faculté de Médecine de Marseille, Etablissement de Transfusion Sanguine Alpes-Provence, Université de la Méditerranée, Marseille, France.
authors.forename: P
authors.initials: P
authors.lastname: Gallian
authors.forename: P
authors.initials: P
authors.lastname: Biagini
authors.forename: S
authors.initials: S
authors.lastname: Zhong
authors.forename: M
authors.initials: M
authors.lastname: Touinssi
authors.forename: W
authors.initials: W
authors.lastname: Yeo
authors.forename: J F
authors.initials: JF
authors.lastname: Cantaloube
authors.forename: H
authors.initials: H
authors.lastname: Attoui
authors.forename: P
authors.initials: P
authors.lastname: de Micco
authors.forename: P J
authors.initials: PJ
authors.lastname: Johnson
authors.forename: X
authors.initials: X
authors.lastname: de Lamballerie
mesh_terms: D001782:Blood Donors; D004266:DNA Virus Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology; D004267:DNA Viruses / Q000145:classification / Q000235:genetics*; D004279:DNA, Viral / Q000032:analysis; D005243:Feces / Q000821:virology; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D016366:Open Reading Frames / Q000235:genetics; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D006435:Renal Dialysis; D012463:Saliva / Q000821:virology
chemical_list: D004279:DNA, Viral