title: Infection with novel respiratory syncytial virus genotype Ontario (ON1) in adult hematopoietic cell transplant recipients, Texas, 2011-2013.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) can cause severe respiratory disease in adult hematopoietic cell transplant (HCT) recipients. RSV subgroups A and B have evolved into multiple genotypes. We report on a recently described RSV genotype (ON1) in a cohort of adult HCT recipients in Texas.
  
  
  METHODS
  Twenty adult HCT recipients were enrolled as a part of an efficacy trial of ribavirin therapy. RSV identification and genotyping was performed using molecular techniques. RSV-specific neutralizing antibody (NAb) responses were measured.
  
  
  RESULTS
  ON1 genotype was detected in 3 of 6 patients in the 2011-2012 season and in 8 of 14 patients in 2012-2013 season. Other genotypes detected were NA1 and BA. NAb levels were low at enrollment. Eight of 9 patients who cleared the RSV infection within 2 weeks mounted a ≥4-fold NAb response, compared with 2 of 8 who shed the virus for >2 weeks. The clinical course of those infected with ON1 was comparable to the course for individuals infected with other genotypes.
  
  
  CONCLUSIONS
  This is the first report of RSV ON1 genotype in the United States, and ON1 genotype was dominant genotype in adult HCT recipients. Interestingly, faster viral clearance was associated with a ≥4-fold NAb response, likely indicating a reconstituted immune system.
authors.affiliation: Department of Molecular Virology and Microbiology.
authors.forename: Vasanthi
authors.initials: V
authors.lastname: Avadhanula
authors.affiliation: Departments of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.affiliation: Departments of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Dimpy P
authors.initials: DP
authors.lastname: Shah
authors.affiliation: Departments of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Shashank S
authors.initials: SS
authors.lastname: Ghantoji
authors.affiliation: Departments of Infectious Diseases, Infection Control, and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Jacques M
authors.initials: JM
authors.lastname: Azzi
authors.affiliation: Department of Molecular Virology and Microbiology.
authors.forename: Letisha O
authors.initials: LO
authors.lastname: Aideyan
authors.affiliation: Department of Molecular Virology and Microbiology.
authors.forename: Minghua
authors.initials: M
authors.lastname: Mei
authors.affiliation: Department of Molecular Virology and Microbiology Department of Pediatrics, Baylor College of Medicine.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Piedra
mesh_terms: D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D005838:Genotype; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*; D018113:Respiratory Syncytial Virus, Human / Q000235:genetics* / Q000276:immunology; D016415:Sequence Alignment; D013781:Texas / Q000453:epidemiology; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D019562:Viral Load; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral
keywords: HCT; RSV; RSV-specific neutralizing antibody; genetic variability; immunocompromised host; novel genotype