Molecular analysis of persistent enterovirus infections.

Human enteroviruses (HEVs) are etiological agents of different clinical entities varying from asymptomatic to mild, severe, or fatal diseases. There is now growing evidence that HEVs can cause or contribute to common chronic diseases. Even though a specific therapies are not yet available, a correct diagnosis is necessary both for diagnostic and epidemiologic purposes. Gene amplification methods and sequencing greatly facilitates the laboratory diagnosis of these conditions and allows discovering previously unsuspected etiopathogenetic associations. In this work, three clinical conditions possibly associated with persistent HEV infections have been investigated: type 1 diabetes in children, the post-polio syndrome in adult patients, as well as clinical cases of inflammatory cardiomyopathy. New methods for HEVs detection have been developed based on bioinformatic studies of HEV sequence databases. These methods have been tested with reference virus strains as well as a wide range of clinical specimens. Our most sensitive assay is based on the detection and sequencing of the viral polymerase (3Dpol) coding region. Different cohorts of patients have been investigated using classical virology and molecular methods. The studies allowed to conclude that HEVs can persist for long periods in humans and that these agents can be associated with endocrine, neurological, and cardiovascular conditions.