Metagenomic study in a predominantly adult cohort with hepatitis of unknown etiology
- 1Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
Abstract
Hepatitis of unknown origin (HUO) remains a diagnostic challenge, with metagenomic studies underexplored in adult cohorts. This study characterized the plasma and fecal virome in a predominantly adult HUO cohort (48 adults and 1 adolescent). A total of 59 samples (44 plasma, 15 fecal) from 49 patients were subjected to ultra-multiplex targeted ribonucleic acid (RNA) sequencing (139 RNA viruses) and unbiased metagenomic sequencing. Targeted sequencing detected HCV in one plasma sample, confirmed by follow-up reverse transcription-polymerase chain reaction (RT-PCR) and seroconversion, leading to case reclassification. Metagenomic sequencing identified HBV sequences in another patient, along with sporadic goose circovirus (GoCV) and an unconfirmed low-level influenza A-like signal. Viral community analysis revealed distinct niche-specific profiles between plasma and feces. Overall, this exploratory study failed to identify a common pathogenic agent, underscoring the etiological heterogeneity of HUO. The detection of known hepatotropic viruses highlights the diagnostic value of metagenomic sequencing in complementing conventional serology and reclassifying some HUO cases. Larger controlled studies are warranted.
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BibTeX
@article{li2026metagenomic,
title = {{Metagenomic study in a predominantly adult cohort with hepatitis of unknown etiology}},
author = {Xinxin Li and Yuanjiao Gao and Ziyu Zhang and Yaqin Zhang and Weihua Cao and Wen Deng and Shiyu Wang and Xin Wei and Zixuan Gao and Linmei Yao and Shuojie Wang and Yao Xie and Minghui Li},
journal = {Biosafety and health},
year = {2026},
month = sep,
doi = {10.1016/j.bsheal.2026.09.003},
url = {https://europepmc.org/article/PMC/PMC13729065},
note = {CC BY},
}
RIS
TY - JOUR
TI - Metagenomic study in a predominantly adult cohort with hepatitis of unknown etiology
AU - Xinxin Li
AU - Yuanjiao Gao
AU - Ziyu Zhang
AU - Yaqin Zhang
AU - Weihua Cao
AU - Wen Deng
AU - Shiyu Wang
AU - Xin Wei
AU - Zixuan Gao
AU - Linmei Yao
AU - Shuojie Wang
AU - Yao Xie
AU - Minghui Li
PY - 2026
DA - 2026/09/18
JO - Biosafety and health
DO - 10.1016/j.bsheal.2026.09.003
UR - https://europepmc.org/article/PMC/PMC13729065
AB - Hepatitis of unknown origin (HUO) remains a diagnostic challenge, with metagenomic studies underexplored in adult cohorts. This study characterized the plasma and fecal virome in a predominantly adult HUO cohort (48 adults and 1 adolescent). A total of 59 samples (44 plasma, 15 fecal) from 49 patients were subjected to ultra-multiplex targeted ribonucleic acid (RNA) sequencing (139 RNA viruses) and unbiased metagenomic sequencing. Targeted sequencing detected HCV in one plasma sample, confirmed by follow-up reverse transcription-polymerase chain reaction (RT-PCR) and seroconversion, leading to case reclassification. Metagenomic sequencing identified HBV sequences in another patient, along with sporadic goose circovirus (GoCV) and an unconfirmed low-level influenza A-like signal. Viral community analysis revealed distinct niche-specific profiles between plasma and feces. Overall, this exploratory study failed to identify a common pathogenic agent, underscoring the etiological heterogeneity of HUO. The detection of known hepatotropic viruses highlights the diagnostic value of metagenomic sequencing in complementing conventional serology and reclassifying some HUO cases. Larger controlled studies are warranted.
SN - 2590-0536
SN - 2096-6962
ER -