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目的 人腺病毒41型(Human adenovirus 41, HAdV-41)是仅次于轮状病毒的，引起儿童腹泻的重要病毒之一，目前临床没有针对HAdV-F41特效药及疫苗可用，本研究旨在了解病毒的流行规律和进化特征。方法 本研究选取2021-2024年广东省某三甲妇儿医院门诊腹泻儿童腺病毒阳性的粪便标本，选取Fiber基因进行扩增及测序分析。结果 研究共纳入26635例腹泻儿童(0-14周岁，平均年龄0.44±0.29岁)，腺病毒阳性儿童共1171例，腺病毒阳性率4.23%，阳性儿童平均年龄0.49±0.31岁。男女患儿阳性个数分别为729例和442例，阳性率分别为4.60%和4.10%(χ2=3.762,P>0.05)。不同年龄组儿童腺病毒阳性率分别为2.72%(0-1岁组)、5.41%(1-2岁组)、7.49%(2-3岁组)、10.08%(3-4岁组)、11.35%(4-5岁组)和3.93%(6-14岁组)，不同年龄组间病毒阳性率差异显著(χ2=328.63,P<0.001)。不同月份腺病毒的阳性率不同，主要以11月至次年1月阳性率最高(4.09%～10.62%)，不同月份之间的病毒阳性率差异具有统计学意义(χ2=99.564,P<0.05)。本研究共扩增HAdV-F41型Fiber基因144个，系统发育进化树分析显示全球范围内腺病毒F41型Long Fiber与Short Fiber基因主要有6个进化分支(Ⅰ-Ⅵ)，除分支IV病毒，其他5个分支病毒均在广州地区流行，广州地区以第V分支为主，其中第Ⅴ和第Ⅵ病毒未在国内其他地区报道流行。核苷酸同源性分析显示，HAdV-F41病毒Long Fiber基因之间的同源性为89%～99%,Short Fiber基因之间的同源性为94%-99%，相同分支内病毒同源性较高，不同分支间病毒同源性较低，Long Fiber基因以第Ⅵ分支与第Ⅲ和第Ⅳ分支之间的病毒的同源性最低，Short Fiber基因以第Ⅳ与Ⅵ分支之间病毒的同源性最低。选择压力分析显示，以腺病毒原型株Long Fiber基因氨基酸序列为参照，广州地区HAdV-F41 Long Fiber基因筛选三个氨基酸位点为负向选择压力位点。与原型株腺病毒Long Fiber基因的氨基酸序列比对结果显示，Long Fiber在263-277位置存在氨基酸缺失，氨基酸片段缺失的病毒主要来自广州地区流行第Ⅰ和Ⅵ分支病毒。结论 HAdV-F41的阳性率与儿童年龄和季节相关，共5种腺病毒在广州地区儿童中流行，以Ⅴ型为主，其中第Ⅴ和第Ⅵ分支病毒仅在广州地区儿童中报道。
Abstract：Objective Human adenovirus 41(HAdV-41) is a major viral pathogen causing pediatric diarrhea, second only to rotavirus. Currently, no specific antiviral therapies or vaccines targeting HAdV-F41 are clinically available. Methods In this study, fecal samples that tested adenovirus-positive were collected from outpatient children with diarrhea in a tertiary maternal and pediatric hospital in Guangdong Province between 2021 and 2024. The Fiber gene was amplified and sequenced to investigate the epidemiological patterns and evolutionary characteristics of circulating strains. Results A total of 26,635 children with diarrhea(0-14 years; mean age 0.44 ± 0.29 years) were enrolled, among whom 1,171 tested positive for adenovirus, yielding a positivity rate of 4.23%. The mean age of adenovirus-positive patients was 0.49 ± 0.31 years. Of the positive cases, 729 were male and 442 were female, with positivity rates of 4.60% and 4.10%, respectively (χ2 = 3.762, P > 0.05). Positivity rates differed significantly across age groups: 2.72%(0-1 year), 5.41%(1-2 years), 7.49%(2-3 years), 10.08%(3-4 years), 11.35%(4-5 years), and 3.93%(6-14 years). (χ2 = 328.63, P < 0.001). Seasonal analysis showed peak detection from November to January(4.09%-10.62%) (χ2 =99.564, P < 0.05). A total of 144 HAdV-F41 Fiber gene sequences were successfully amplified. Phylogenetic analysis demonstrated that HAdV-F41 Long Fiber and Short Fiber genes cluster globally into six evolutionary lineages(Ⅰ-Ⅵ). Five of these lineages(Excluding lineage Ⅳ) were detected in Guangzhou,China, with lineage Ⅴ predominating. Notably, lineages Ⅴ and Ⅵ have not been reported previously in other regions of China. Nucleotide identity among Long Fiber sequences ranged from 89%-99%, and among Short Fiber sequences from 94% to 99%. Viral sequences within the same lineage exhibited higher homology than those across lineages. The lowest homology for Long Fiber genes occurred between lineage Ⅵ and lineages Ⅲ/Ⅳ, while for Short Fiber genes it occurred between lineages Ⅳ and Ⅵ. Conclusion Selection pressure analysis identified three negatively selected amino acid sites in the Long Fiber protein of Guangzhou HAdV-F41 strains relative to the prototype strain. Comparative sequence analysis revealed a deletion spanning amino acid positions 263-277 in the Long Fiber protein, predominantly observed in strains belonging to lineages Ⅰ and Ⅵ circulating in Guangzhou.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250225
中图分类号:R725.1;R181.3
引用信息:
[1]钟田花,董文雅,纪存委,等.2021‑2024年广州腹泻儿童中人腺病毒41型的流行及分子进化分析[J].病毒学报,2026,42(02):572-582.DOI:10.13242/j.cnki.bingduxuebao.250225.
基金信息:
广东省医学科学技术研究基金（项目号：A2023461）,题目：基于CRISPR-Cas系统开发腺病毒恒温快速检测体系及其临床诊断应用的研究;广东省医学科学技术研究基金（项目号：B2024082）,题目：广州地区腹泻儿童腺病毒分子流行病学及基因进化特征研究~~
2025-12-08
2025-12-08
2025-12-08