Intra-host viral population dynamics during acute hepatitis E virus infection.

Intra-host HEV populations during acute infection show limited diversity but exhibit early selective pressures, with four polymerase mutations enriched among asymptomatic donors.

• Why it matters: Understanding early viral evolution is crucial because it influences infection outcomes and treatment responses, yet little is known about HEV dynamics during the initial infection phase.
• What they did: The study analyzed over 80 asymptomatic blood donors using sensitive amplicon sequencing, identifying recurrent mutations, temporal shifts in variants, and defective genomes during acute HEV-3 infection.
• The result: Findings reveal constrained viral diversity with ongoing selection, providing mechanistic insights into early intra-host evolution, and establishing a basis for linking genetic variation to clinical prognosis.