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Journal of Virology, November 1999, p. 9604-9608, Vol. 73, No. 11
0022-538X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Quasispecies of TT Virus (TTV) with Sequence Divergence in
Hypervariable Regions of the Capsid Protein in Chronic TTV
Infection
Tsutomu
Nishizawa,1
Hiroaki
Okamoto,1
Fumio
Tsuda,2
Tatsuya
Aikawa,3
Yoshiki
Sugai,4
Keiko
Konishi,5
Yoshihiro
Akahane,6
Masato
Ukita,1
Takeshi
Tanaka,7
Yuzo
Miyakawa,8 and
Makoto
Mayumi1,*
Immunology Division and Division of Molecular Virology,
Jichi Medical School, Tochigi-Ken 329-0498,1
Department of Medical Sciences, Toshiba General Hospital,
Tokyo 140-8522,2 Aikawa Internal
Hospital, Ibaraki-Ken 310-0851,3
Department of Internal Medicine, Iwaki Kyoritsu General
Hospital, Fukushima-Ken 973-8402,4
Department of Clinical Pathology, Kanazawa National
Hospital, Ishikawa-Ken 920-0935,5 First
Department of Internal Medicine, Yamanashi Medical University,
Yamanashi-Ken 409-3898,6 Japanese
Red Cross Saitama Blood Center, Saitama-Ken
338-0001,7 and Miyakawa Memorial
Research Foundation, Tokyo 107-0062,8 Japan
Received 3 May 1999/Accepted 21 July 1999
 |
ABSTRACT |
Three hypervariable regions were identified in a central portion of
open reading frame 1 of TT virus DNA, which codes for a putative capsid
protein of 770 amino acids. TT virus circulates as quasispecies, with
many amino acid substitutions in hypervariable regions, to evade immune
surveillance of the hosts and to establish a persistent infection.
 |
TEXT |
Late in 1997, a nonenveloped,
single-stranded DNA virus was recovered from a patient, who developed
posttransfusion hepatitis not related to any of the known hepatitis
viruses (non-A through non-G), and named TT virus (TTV) (14,
17). Because TTV has a circular genomic structure (9, 10,
20), it is classified tentatively in the Circoviridae
family (6). Despite being a DNA virus, TTV has an extremely
wide sequence divergence which causes it to fall into at least 16 genotypes separated by an evolutionary distance >0.30 (4, 10, 11,
13, 17-20, 22, 25-27).
TTV may have a hypervariable region (HVR), because amino acid
substitutions among distinct TTV strains of the same genotype are found
more frequently in a central portion of open reading frame 1 (ORF1)
than in the other genomic regions (10, 24). For further
defining the HVR of TTV, the amino acid sequences of the two ORFs (ORF1
and ORF2) of nine TTV isolates of genotype 1a, including three newly
sequenced and six previously reported (10, 17, 24), were
compared. Furthermore, HVR sequences were compared among the many TTV
clones recovered from the sera of five individuals with chronic or
acute TTV infection. The quasispecies nature of circulating TTV may
help it evade immune surveillance and establish persistent infection,
as is seen for hepatitis C virus (HCV) and human immunodeficiency virus
type 1 (2, 7, 8, 16, 29).
HVRs in ORF1 of TTV.
Two patients (TRM1, with HCV-associated
hepatocellular carcinoma, and TK16, with non-A through non-G acute
hepatitis) and one blood donor (TP1-3) were infected with TTV of
genotype 1a. TTV DNAs in their plasma were sequenced (3,308 nucleotides
[nt] corresponding to >85% of the genomic sequence) by a
long-distance PCR method for amplifying 3.4 kb (19). The
sequences were compared with the sequences of six reported isolates of
the same genotype (10, 17, 24) within various genomic regions.
There were three regions with marked sequence divergence located in the
same positions on the genome of nine isolates, including the three
obtained in the present study. They were in a central portion of ORF1
and spanned amino acids (aa) 275 to 296, 314 to 360, and 372 to 402 (Fig. 1) and were designated HVR1, HVR2,
and HVR3, respectively. The TTV HVRs were located outside the N22 region (14), the sequence of which is used for detecting TTV DNA and classifying various genotypes (4, 17-20, 22,
25-27) (Fig. 1).

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FIG. 1.
Genomic organization of TTV and positions of the three
HVRs in ORF1. The genomic organization of the prototype TTV isolate of
genotype 1a (TA278), consisting of 3,853 nt (17, 20), is
shown, with the positions of the two ORFs indicated by arrows. The
positions of HVR1 (nt 1411 to 1476 [aa 275 to 296]), HVR2 (nt 1528 to
1668 [aa 314 to 360]), and HVR3 (nt 1702 to 1794 [aa 372 to 402])
are indicated by black bars in ORF1. A nucleotide sequence including
the HVRs was amplified by PCR with heminested primers with products
indicated at the bottom. The position of the N22 clone (14),
from which primers for detection and genotyping of TTV DNA are deduced
(18, 19), is indicated.
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|
Table 1 compares the nucleotide and amino
acid sequences of ORF1 among the nine isolates. TRM1 was used as the
standard, because comparison with the other eight isolates gave the
lowest amount of sequence divergence. The eight isolates were different from TRM1 at 1.7 to 7.2% (mean, 2.9%) of the 2,310 nt in ORF1. Divergent nucleotides clustered in HVRs at a rate of 31.9 to 68.1%. Within the three HVRs, totalling 300 nt, 15 to 53 nt (mean, 31.6 nt)
were divergent, corresponding to 5 to 18% (mean, 10.5%) of the 300 nt. Sequences outside the three HVRs in ORF1 (total, 2,010 nt) were
much conserved, by contrast, showing a divergence of only 0.7 to 5.6%
(mean, 1.7%). Nucleotide sequence divergence occurred most frequently
in the third letter of a codon and accounted for a mean of 68.7%,
which was much more frequent than the 39.2% occurrence in HVRs. Of the
770 aa coded for by ORF1, 20 to 32 aa (mean, 28.2 aa) were divergent,
corresponding to 2.6 to 4.2% (mean, 3.7%) of the 770 aa. Of the
divergent amino acids, 46 to 86% occurred in HVRs. Of the 100 aa
representing the three HVRs, 12 to 25 aa (mean, 18.9 aa) were
divergent, accounting for 12 to 25% (mean, 18.9%) of the 100 aa.
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TABLE 1.
Comparison of nucleotide and amino acid sequences within
the HVRs and the remaining regions in ORF1 between the TRM1 isolate
and the other eight isolates of the same genotype (1a)
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|
Sequence divergence in HVRs of TTV clones from patients with
chronic TTV infection (C1 and C2) and its evolution with time.
Sequential sera were obtained from two patients with non-A through
non-G chronic hepatitis complicated by cirrhosis (C1 and C2), both of
whom were persistently infected with TTV. C1 had received transfusions
during a hysterectomy at the age of 44, and was diagnosed with
cirrhosis at 52 years of age. TTV DNA was recovered from serum samples
taken at 60, 64, and 68 years of age. C2 was diagnosed with cirrhosis
at the age of 74. TTV DNA was recovered from serum samples taken at 79 and 81 years of age.
An 849-bp sequence in ORF1 bearing HVRs (Fig.
1) was amplified by PCR
in the presence of
TaKaRa Ex Taq (TaKaRa Shuzo Co.,
Shiga,
Japan) with heminested primers. The first-round PCR was
performed with
NG161 (sense, 5'-GCA ACC GCA GCG GAT ATG CAA TAT
CCG TTC-3' [nt 1321 to 1350]) and NG063 (antisense, 5'-CTG GCA
TTT TAC CAT TTC CAA AGT
T-3' [nt 2161 to 2185]) for 35 cycles,
and the second-round PCR was
done for 25 cycles with NG152 (sense,
5'-TGC AAT ATC CGT TCG GCT CAC
CAC-3' [nt 1337 to 1360]) and NG063.
The conditions for both PCR
methods were: 94°C, 30 s; 60°C, 30
s; 72°C, 60 s
(with an additional 7 min for the last cycle). The
amplification
products by the first-round PCR measured 865 bp,
and those by the
second-round PCR measured 849
bp.
Products of the second-round PCR were inserted into pT7BlueT-Vector,
and the independent TTV clones thus obtained were confirmed
to belong
to genotype 1a by PCR with primers specific for this
genotype, i.e.,
NG164 (sense, 5'-GGA TAT GTA GAA TTT TGT GCA-3'
[nt 2020 to 2040])
and NG165 (antisense, 5'-AAA GCC TTT TGT GGG
GTC TG-3' [nt 2126 to
2145]). The obtained clones were sequenced
with the BigDye Terminator
Cycle Sequence Ready Reaction Kit (PE
Applied Biosystems, Foster City,
Calif.). Sequence analysis of
TTV clones was performed with Genetyx-Mac
version 10.1 (Software
Development Co., Tokyo, Japan) and ODEN program
version 1.1.1
(
5) of DDBJ (DNA Data Bank of Japan, National
Institute of
Genetics, Mishima,
Japan).
Ten TTV clones from C1 at year 0 revealed quasispecies with marked
sequence divergence in the HVRs, similar to those at years
3.5 and 7.5 (Fig.
2a). The sequences of TTV clones at
year 0 was
somewhat similar to those at year 3.5; such a similarity was
observed
also between TTV clones at years 3.5 and 7.5. Ten TTV clones
from
C2 also showed remarkable heterogeneity in HVR sequences from
both
testings (Fig.
2b). There was a close relationship between
clones
obtained at years 0 and 3.3 from C2, which would reflect
continuous
evolution in the HVR sequence.

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FIG. 2.
Amino acid sequences of the three HVRs of TTV clones in
five patients with chronic (C1 and C2) or acute (A1, A2, and A3)
infection. (a and b) Sequences of HVR1, HVR2, and HVR3 are shown for 10 clones, each obtained from sequential sera of two patients with chronic
infection. The consensus sequence (cons) in 10 clones at year 0 is
indicated at the top. (c) Sequences of 10 clones each from three
patients with acute infection. Dashes indicate the same amino acids as
those in the consensus sequence (cons).
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|
Sequence of HVRs in TTV clones from three patients with acute TTV
infection (A1, A2, and A3).
Sera were obtained from two patients
with posttransfusion non-A through non-G hepatitis associated with
acute TTV infection (14), 10 and 8 weeks after they received
transfusions, respectively. An additional serum sample was obtained
from one patient with HCV-associated hepatocellular carcinoma 6 weeks
after he contracted sporadic TTV infection. His transaminase levels did
not change during the 8 weeks that TTV DNA was detected in his serum.
All three patients with acute infection lost TTV DNA from their serum by 2 to 7 weeks after the time of testing.
The sequences of the HVRs of 10 TTV clones obtained from each of the
patients' sera are shown in Fig.
2c; they were recovered
from
unfractionated sera (Table
2). In sharp
contrast to the
marked sequence divergence in TTV clones from the
patients with
chronic infection, the 10 clones from the three patients
with
acute infection were strikingly homogeneous in the HVR amino acid
sequences.
TTV complexed with IgG in sera from patients with chronic
infection.
TTV particles in sera were immunoprecipitated with
ICN/CAPPEL goat antiserum to human immunoglobulin G (IgG) (whole
molecule) (ICN Biomedicals, Aurora, Ohio), and supernatant was
separated from precipitate (28). They were tested for TTV
DNA by PCR (Table 2). Samples were judged to contain TTV complexed with
IgG when precipitate generated a higher density of amplification
products than supernatant after treatment with goat antiserum to human IgG and when no significant amplification signals were observed in the
precipitate fraction after treatment with normal goat serum (ICN Biochemicals).
TTV DNA was detected only in the precipitate fraction of sera from two
patients with chronic infection taken at different
time points (Table
2). In view of the sensitivity of this experiment,
TTV particles in the
supernatant were deduced to be less than
1/10 to 1/100 of those in the
precipitate for these two patients,
with serum titers at
10
3 to 10
4 copies/ml.
By contrast, TTV particles were detected in supernatant fractions from
all three patients with acute infection. Two patients
(A1 and A3) were
tested when they had peak TTV DNA titers, and
their sera had higher TTV
DNA titers in precipitate than supernatant.
Serum of the remaining
patient (A2) taken 3 weeks earlier than
the peak TTV DNA level,
however, possessed a much higher TTV DNA
titer in supernatant than
precipitate.
Discussion.
The Circoviridae family consists of
nonenveloped, single-stranded circular DNA viruses (6);
there have been only three animal circoviruses known, i.e., chicken
anemia virus, beak and feather disease virus of parrots, and porcine
circovirus (1, 6, 12, 15). Due to its circular genomic
structure (9, 10, 20), TTV may qualify as a fourth animal
circovirus, although its genomic size (3,818 to 3,853 nt, depending on
genotype) is much larger than those of the other three (1,758 to 2,319 nt) (1, 12, 15, 20).
In spite of being a DNA virus, TTV has an extremely high level of
sequence divergence, ranging to 60.5% for the entire genome
(
20); at least 16 genotypes that differ by >30% from one
another
have been distinguished (
19). The reason for the
outstanding
genetic heterogeneity of TTV is not clear. The replication
of
TTV might involve reverse transcription, making for an accelerated
mutation rate as is the case for hepatitis B virus (
23), a
double-stranded
DNA virus encoding a reverse transcriptase; a sequence
motif for
reverse transcriptase has not been identified in the TTV
genome,
however.
Nucleotide sequences vary considerably even among TTV isolates of the
same genotype. Sequence divergence resulting in amino
acid conversions
is the highest in a central portion of ORF1 (
10,
24), the
translation product of which has an arginine-rich sequence
in the N
terminus. By analogy with VP1 of chicken anemia virus,
which also has
this sequence (
1,
15), the ORF1 in TTV may
encode a capsid
protein. Comparison of nine TTV isolates of genotype
1a highlighted
three regions in ORF1 that had a markedly divergent
amino acid sequence
(Fig.
1). They were designated HVR1, HVR2,
and HVR3 and coded for 22, 47, and 31 aa,
respectively.
The nine TTV isolates of genotypes 1a were 92 to 96% similar in the
amino acid sequence of the ORF1 product. Most amino acid
substitutions
in ORF1 (47 to 86%) clustered in HVRs that spanned
100 aa altogether;
regions outside HVRs in ORF1 were well conserved,
with a similarity of

98%. HVRs in TTV are comparable to the HVR
in chicken anemia virus,
which stretches for 13 aa (position,
139 to 151) in the 450-aa VP1
(
21).
In individuals with chronic infection, TTV circulates as
quasispecies, with sequence divergence in the HVR. TTV evolves in
hosts
by changing its HVR sequences to escape immune surveillance.
The
adaptability of the HVR for viral persistence has been well
established
for HCV and human immunodeficiency virus type 1 (
2,
7,
8,
16,
29). Quasispecies of TTV due to variation
in the HVR were found
restricted to hosts with chronic infection.
Circulating TTV in hosts
with acute resolving infection, rarely,
if ever, showed sequence
divergence in the HVR (Fig.
2).
Should variation in HVR reflect a strategy of TTV to evade immune
surveillance of hosts, humoral antibodies to HVR sequences
may well be
present in the circulation. Antibodies to HVR sequences
would bind with
circulating TTV to form immune complexes, as is
seen in chronic HCV
infection (
3). This was actually the case
for TTV (Table
2).
In individuals with chronic TTV infection,
by far the most TTV
particles in serum were precipitated with
goat anti-human IgG, thereby
indicating that they would form immune
complexes in the
circulation. In individuals with acute resolving
infection, by
contrast, free TTV particles uncomplexed with IgG
always
occurred, in amounts exceeding those of complexed TTV in
some
instances.
Nucleotide sequence accession numbers.
The nucleotide sequence
data in this report have been deposited in the DDBJ/EMBL/GenBank
nucleotide sequence databases under accession no. AB026345 to AB026347
for 3,308 nt of TRM1, TK16, and TP1-3 and AB026348 to AB026427 for 80 TTV isolates consisting of 800 nt covering the HVRs.
 |
FOOTNOTES |
*
Corresponding author. Mailing address:
Minamikawachi-Machi, Tochigi-Ken 329-0498, Japan. Phone:
81-285-58-7404. Fax: 81-285-44-1557. E-mail:
immundiv{at}jichi.ac.jp.
 |
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Variable and hypervariable domains are found in the regions of HCV corresponding to the flavivirus envelope and NS1 proteins and the pestivirus envelope glycoproteins.
Virology
180:842-848[Medline].
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Journal of Virology, November 1999, p. 9604-9608, Vol. 73, No. 11
0022-538X/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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