Abstract: Theiler's disease is an acute hepatitis in horses that is associated with the administration of equine blood products; its etiologic agent has remained unknown for nearly a century. Here, we used massively parallel sequencing to explore samples from a recent Theiler's disease outbreak. Metatranscriptomic analysis of the short sequence reads identified a 10.5-kb sequence from a previously undescribed virus of the Flaviviridae family, which we designate "Theiler's disease-associated virus" (TDAV). Phylogenetic analysis clusters TDAV with GB viruses of the recently proposed Pegivirus genus, although it shares only 35.3% amino acid identity with its closest relative, GB virus D. An epidemiological survey of additional horses from three separate locations supports an association between TDAV infection and acute serum hepatitis. Experimental inoculation of horses with TDAV-positive plasma provides evidence that several weeks of viremia preceded liver injury and that liver disease may not be directly related to the level of viremia. Like hepatitis C virus, the best characterized Flaviviridae species known to cause hepatitis, we find TDAV is capable of efficient parenteral transmission, engendering acute and chronic infections associated with a diversity of clinical presentations ranging from subclinical infection to clinical hepatitis.
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This study identifies a new type of virus from the Flaviviridae family, named “Theiler’s disease-associated virus” (TDAV), that’s linked to Theiler’s disease outbreak which causes acute hepatitis in horses. The researchers found that TDAV infections occur several weeks before liver injury is observed, hinting towards a unique disease progression pattern.
Identification and Classification of TDAV
The research utilized advanced sequencing techniques on samples from a recent Theiler’s disease outbreak in horses. Analysis of these sequences revealed a 10.5-kb sequence from a previously unclassified virus, which the research team named “Theiler’s disease-associated virus” (TDAV).
Phylogenetic analysis showed that TDAV is clustered with GB viruses of the recently proposed Pegivirus genus. However, it shares a relatively low level of similarity (35.3% amino acid identity) with its closest relative, GB virus D.
Epidemiological Study and Inoculation Experiment
An epidemiological survey of additional horses from three different locations backed the link between TDAV infection and acute serum hepatitis, helping establish TDAV as a possible etiological agent of Theiler’s disease.
To further investigate the disease progression of TDAV, experimental inoculation was conducted. The researchers infected horses with TDAV-positive plasma and found that disease activity, measured by viremia, starts several weeks before any liver injury, implying a specific pathogenesis pattern of TDAV infection.
TDAV Transmission and Clinical Presentations
Similarly to hepatitis C virus (a well-studied member of the Flaviviridae family), TDAV showed efficient parenteral transmission, meaning it can spread effectively via direct body fluid contact.
The study shows that TDAV can lead to both acute and chronic infections with varying clinical presentations. These can range from subclinical infection (no visible symptoms) to clinical hepatitis, indicating a broad spectrum of disease severity associated with TDAV infection.
Cite This Article
APA
Chandriani S, Skewes-Cox P, Zhong W, Ganem DE, Divers TJ, Van Blaricum AJ, Tennant BC, Kistler AL.
(2013).
Identification of a previously undescribed divergent virus from the Flaviviridae family in an outbreak of equine serum hepatitis.
Proc Natl Acad Sci U S A, 110(15), E1407-E1415.
https://doi.org/10.1073/pnas.1219217110
Department of Infectious Diseases, Novartis Institutes for BioMedical Research, Emeryville, CA 94608, USA.
Skewes-Cox, Peter
Zhong, Weidong
Ganem, Donald E
Divers, Thomas J
Van Blaricum, Anita J
Tennant, Bud C
Kistler, Amy L
MeSH Terms
Animals
Botulinum Toxins / metabolism
Cluster Analysis
Disease Outbreaks
Flaviviridae / genetics
Flaviviridae Infections / veterinary
Flaviviridae Infections / virology
Gene Library
Genome, Viral
Hepatitis, Viral, Animal / virology
Horses / virology
Metagenomics
Molecular Sequence Data
Phylogeny
RNA, Viral / metabolism
Sequence Analysis, DNA
Conflict of Interest Statement
Conflict of interest statement: A.L.K., S.C., P.S.-C., T.J.D., and B.C.T. are coinventors on a patent application relating to the results herein. A.L.K., S.C., P.S.-C., D.E.G., and W.Z. are employees of the Novartis Institutes for BioMedical Research.
References
This article includes 42 references
Kahn CM, Line S, editors. 2011. Merck Veterinary Manual (Merck, Whitehouse Station, NJ), 9th Ed. Available at www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/22802.htm.
Theiler A. Acute liver-atrophy and parenchymatous hepatitis in horses. The Fifth and Sixth Reports of the Director of Veterinary Research, April, 1918 1919.
Panciera RJ. Serum hepatitis in the horse. J Am Vet Med Assoc 1969;155(2):408–410.
Cox HR, Philip CB, Marsh H, Kilpatrick JW. Observations incident to an outbreak of equine encephalomyelitis in the Bitterroot valley of western Montana. J Am Vet Med Assoc 1938;93:225–232.
Herniou EA, Olszewski JA, O’Reilly DR, Cory JS. Ancient coevolution of baculoviruses and their insect hosts. J Virol 2004;78(7):3244–3251.
Graham FL, Smiley J, Russell WC, Nairn R. Characteristics of a human cell line transformed by DNA from human adenovirus type 5. J Gen Virol 1977;36(1):59–74.
Epstein JH. Identification of GBV-D, a novel GB-like flavivirus from old world frugivorous bats (Pteropus giganteus) in Bangladesh. PLoS Pathog 2010;6:e1000972.
Stapleton JT, Foung S, Muerhoff AS, Bukh J, Simmonds P. The GB viruses: A review and proposed classification of GBV-A, GBV-C (HGV), and GBV-D in genus Pegivirus within the family Flaviviridae. J Gen Virol 2011;92(Pt 2):233–246.
Tellinghuisen TL, Marcotrigiano J, Rice CM. Structure of the zinc-binding domain of an essential component of the hepatitis C virus replicase. Nature 2005;435(7040):374–379.
Tellinghuisen TL, Marcotrigiano J, Gorbalenya AE, Rice CM. The NS5A protein of hepatitis C virus is a zinc metalloprotein. J Biol Chem 2004;279(47):48576–48587.
Jopling CL, Yi M, Lancaster AM, Lemon SM, Sarnow P. Modulation of hepatitis C virus RNA abundance by a liver-specific MicroRNA. Science 2005;309(5740):1577–1581.
Uto H, Mawatari S, Kumagai K, Ido A, Tsubouchi H. Clinical features of hepatitis C virus carriers with persistently normal alanine aminotransferase levels. Hepat Mon 2012;12(2):77–84.
Anand B-S, Velez M. Assessment of correlation between serum titers of hepatitis C virus and severity of liver disease. World J Gastroenterol 2004;10(16):2409–2411.
Puoti C. Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase levels. Hepatology 1997;26(6):1393–1398.
Runckel C. Temporal analysis of the honey bee microbiome reveals four novel viruses and seasonal prevalence of known viruses, Nosema, and Crithidia. PLoS ONE 2011;6(6):e20656.
Tamura K. MEGA5: Molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol 2011;28(10):2731–2739.
Xu W, Wang W, Liu Q. Identification of a novel pegivirus in reindeer (Rangifer tarandus valentinae) in Northeastern China. BMC Vet Res 2025 Dec 2;22(1):9.
Cardone R, Buonavoglia A, Lanave G, Vasinioti VI, Mininni V, Lorusso E, Decaro N, Martella V, Elia G, Diakoudi G. Description of an Equine Hepacivirus Cluster in a Horse Stable in Italy. Transbound Emerg Dis 2023;2023:5251034.
Chen S, Wang H, Dzakah EE, Rashid F, Wang J, Tang S. The Second Human Pegivirus, a Non-Pathogenic RNA Virus with Low Prevalence and Minimal Genetic Diversity. Viruses 2022 Aug 23;14(9).
Chang WS, Rose K, Holmes EC. Meta-transcriptomic analysis of the virome and microbiome of the invasive Indian myna (Acridotheres tristis) in Australia. One Health 2021 Dec;13:100360.
Cebriá-Mendoza M, Bracho MA, Arbona C, Larrea L, Díaz W, Sanjuán R, Cuevas JM. Exploring the Diversity of the Human Blood Virome. Viruses 2021 Nov 21;13(11).
Sims S, Michaelsen K, Burkhard S, Fraefel C. In Vitro Comparison of the Internal Ribosomal Entry Site Activity from Rodent Hepacivirus and Pegivirus and Construction of Pseudoparticles. Adv Virol 2021;2021:5569844.
Porter AF, Pettersson JH, Chang WS, Harvey E, Rose K, Shi M, Eden JS, Buchmann J, Moritz C, Holmes EC. Novel hepaci- and pegi-like viruses in native Australian wildlife and non-human primates. Virus Evol 2020 Jul;6(2):veaa064.
Zhu N, Xu R, Tang W, Wang H, Wan Z, Wu X, Fu Y, Tang S, Yu S. [Detection of a novel human pegivirus HPgV-2 in healthy blood donors and recipients of multiple transfusions: implications for blood safety]. Nan Fang Yi Ke Da Xue Xue Bao 2018 Jul 30;38(7):842-849.
Momoi Y, Matsuu A. Detection of severe fever with thrombocytopenia syndrome virus and other viruses in cats via unbiased next-generation sequencing. J Vet Diagn Invest 2021 Mar;33(2):279-282.
Heffron AS, Lauck M, Somsen ED, Townsend EC, Bailey AL, Sosa M, Eickhoff J, Capuano Iii S, Newman CM, Kuhn JH, Mejia A, Simmons HA, O'Connor DH. Discovery of a Novel Simian Pegivirus in Common Marmosets (Callithrix jacchus) with Lymphocytic Enterocolitis. Microorganisms 2020 Sep 30;8(10).
Wu Z, Wu Y, Zhang W, Merits A, Simmonds P, Wang M, Jia R, Zhu D, Liu M, Zhao X, Yang Q, Wu Y, Zhang S, Huang J, Ou X, Mao S, Liu Y, Zhang L, Yu Y, Tian B, Pan L, Rehman MU, Chen S, Cheng A. The First Nonmammalian Pegivirus Demonstrates Efficient In Vitro Replication and High Lymphotropism. J Virol 2020 Sep 29;94(20).
Xie Y, Wang X, Feng J, Wei L, Li G, Si G, Chen Y, Yan H, He D. The Prevalence, Genetic Characterization, and Evolutionary Analysis of Porcine Pegivirus in Guangdong, China. Virol Sin 2021 Feb;36(1):52-60.
Arhab Y, Bulakhov AG, Pestova TV, Hellen CUT. Dissemination of Internal Ribosomal Entry Sites (IRES) Between Viruses by Horizontal Gene Transfer. Viruses 2020 Jun 4;12(6).
Wan Z, Liu J, Hu F, Shui J, Li L, Wang H, Tang X, Hu C, Liang Y, Zhou Y, Cai W, Tang S. Evidence that the second human pegivirus (HPgV-2) is primarily a lymphotropic virus and can replicate independent of HCV replication. Emerg Microbes Infect 2020;9(1):485-495.
Mrzljak A, Tabain I, Premac H, Bogdanic M, Barbic L, Savic V, Stevanovic V, Jelic A, Mikulic D, Vilibic-Cavlek T. The Role of Emerging and Neglected Viruses in the Etiology of Hepatitis. Curr Infect Dis Rep 2019 Nov 21;21(12):51.
Kennedy J, Pfankuche VM, Hoeltig D, Postel A, Keuling O, Ciurkiewicz M, Baumgärtner W, Becher P, Baechlein C. Genetic variability of porcine pegivirus in pigs from Europe and China and insights into tissue tropism. Sci Rep 2019 Jun 3;9(1):8174.
Lei D, Ye Y, Lin K, Zhang F, Huang D, Li K, Yuan W, Wu Q, Ding Z, Wang L, Song D, Tang Y. Detection and genetic characterization of porcine pegivirus from pigs in China. Virus Genes 2019 Apr;55(2):248-252.
Tomlinson JE, Kapoor A, Kumar A, Tennant BC, Laverack MA, Beard L, Delph K, Davis E, Schott Ii H, Lascola K, Holbrook TC, Johnson P, Taylor SD, McKenzie E, Carter-Arnold J, Setlakwe E, Fultz L, Brakenhoff J, Ruby R, Trivedi S, Van de Walle GR, Renshaw RW, Dubovi EJ, Divers TJ. Viral testing of 18 consecutive cases of equine serum hepatitis: A prospective study (2014-2018). J Vet Intern Med 2019 Jan;33(1):251-257.
Lu G, Huang J, Yang Q, Xu H, Wu P, Fu C, Li S. Identification and genetic characterization of hepacivirus and pegivirus in commercial equine serum products in China. PLoS One 2017;12(12):e0189208.
Tsunoda I, Omura S, Sato F, Kusunoki S, Fujita M, Park AM, Hasanovic F, Yanagihara R, Nagata S. Neuropathogenesis of Zika Virus Infection : Potential Roles of Antibody-Mediated Pathology. Acta Med Kinki Univ 2016;41(2):37-52.
Dimitrov KM, Sharma P, Volkening JD, Goraichuk IV, Wajid A, Rehmani SF, Basharat A, Shittu I, Joannis TM, Miller PJ, Afonso CL. A robust and cost-effective approach to sequence and analyze complete genomes of small RNA viruses. Virol J 2017 Apr 7;14(1):72.
Smith DB, Becher P, Bukh J, Gould EA, Meyers G, Monath T, Muerhoff AS, Pletnev A, Rico-Hesse R, Stapleton JT, Simmonds P. Proposed update to the taxonomy of the genera Hepacivirus and Pegivirus within the Flaviviridae family. J Gen Virol 2016 Nov;97(11):2894-2907.
Baechlein C, Grundhoff A, Fischer N, Alawi M, Hoeltig D, Waldmann KH, Becher P. Pegivirus Infection in Domestic Pigs, Germany. Emerg Infect Dis 2016 Jul;22(7):1312-4.
Berg MG, Lee D, Coller K, Frankel M, Aronsohn A, Cheng K, Forberg K, Marcinkus M, Naccache SN, Dawson G, Brennan C, Jensen DM, Hackett J Jr, Chiu CY. Discovery of a Novel Human Pegivirus in Blood Associated with Hepatitis C Virus Co-Infection. PLoS Pathog 2015 Dec;11(12):e1005325.
Hansen TA, Fridholm H, Frøslev TG, Kjartansdóttir KR, Willerslev E, Nielsen LP, Hansen AJ. New Type of Papillomavirus and Novel Circular Single Stranded DNA Virus Discovered in Urban Rattus norvegicus Using Circular DNA Enrichment and Metagenomics. PLoS One 2015;10(11):e0141952.
Thézé J, Lowes S, Parker J, Pybus OG. Evolutionary and Phylogenetic Analysis of the Hepaciviruses and Pegiviruses. Genome Biol Evol 2015 Oct 21;7(11):2996-3008.
Shi M, Lin XD, Vasilakis N, Tian JH, Li CX, Chen LJ, Eastwood G, Diao XN, Chen MH, Chen X, Qin XC, Widen SG, Wood TG, Tesh RB, Xu J, Holmes EC, Zhang YZ. Divergent Viruses Discovered in Arthropods and Vertebrates Revise the Evolutionary History of the Flaviviridae and Related Viruses. J Virol 2016 Jan 15;90(2):659-69.
Kapoor A, Kumar A, Simmonds P, Bhuva N, Singh Chauhan L, Lee B, Sall AA, Jin Z, Morse SS, Shaz B, Burbelo PD, Lipkin WI. Virome Analysis of Transfusion Recipients Reveals a Novel Human Virus That Shares Genomic Features with Hepaciviruses and Pegiviruses. mBio 2015 Sep 22;6(5):e01466-15.
Li L, Giannitti F, Low J, Keyes C, Ullmann LS, Deng X, Aleman M, Pesavento PA, Pusterla N, Delwart E. Exploring the virome of diseased horses. J Gen Virol 2015 Sep;96(9):2721-2733.
Pfaender S, Walter S, Todt D, Behrendt P, Doerrbecker J, Wölk B, Engelmann M, Gravemann U, Seltsam A, Steinmann J, Burbelo PD, Klawonn F, Feige K, Pietschmann T, Cavalleri JV, Steinmann E. Assessment of cross-species transmission of hepatitis C virus-related non-primate hepacivirus in a population of humans at high risk of exposure. J Gen Virol 2015 Sep;96(9):2636-2642.
Baechlein C, Fischer N, Grundhoff A, Alawi M, Indenbirken D, Postel A, Baron AL, Offinger J, Becker K, Beineke A, Rehage J, Becher P. Identification of a Novel Hepacivirus in Domestic Cattle from Germany. J Virol 2015 Jul;89(14):7007-15.
Jensen RH, Mollerup S, Mourier T, Hansen TA, Fridholm H, Nielsen LP, Willerslev E, Hansen AJ, Vinner L. Target-dependent enrichment of virions determines the reduction of high-throughput sequencing in virus discovery. PLoS One 2015;10(4):e0122636.
Scheel TK, Simmonds P, Kapoor A. Surveying the global virome: identification and characterization of HCV-related animal hepaciviruses. Antiviral Res 2015 Mar;115:83-93.
Strong MJ, Lin Z, Flemington EK. Expanding the conversation on high-throughput virome sequencing standards to include consideration of microbial contamination sources. mBio 2014 Oct 28;5(6):e01989.
Stapleton JT, Xiang J, McLinden JH, Bhattarai N, Chivero ET, Klinzman D, Kaufman TM, Chang Q. A novel T cell evasion mechanism in persistent RNA virus infection. Trans Am Clin Climatol Assoc 2014;125:14-24; discussion 24-6.
Sibley SD, Lauck M, Bailey AL, Hyeroba D, Tumukunde A, Weny G, Chapman CA, O'Connor DH, Goldberg TL, Friedrich TC. Discovery and characterization of distinct simian pegiviruses in three wild African Old World monkey species. PLoS One 2014;9(2):e98569.
Kao RR, Haydon DT, Lycett SJ, Murcia PR. Supersize me: how whole-genome sequencing and big data are transforming epidemiology. Trends Microbiol 2014 May;22(5):282-91.
Ghai RR, Sibley SD, Lauck M, Dinis JM, Bailey AL, Chapman CA, Omeja P, Friedrich TC, O'Connor DH, Goldberg TL. Deep sequencing identifies two genotypes and high viral genetic diversity of human pegivirus (GB virus C) in rural Ugandan patients. J Gen Virol 2013 Dec;94(Pt 12):2670-2678.
Naccache SN, Greninger AL, Lee D, Coffey LL, Phan T, Rein-Weston A, Aronsohn A, Hackett J Jr, Delwart EL, Chiu CY. The perils of pathogen discovery: origin of a novel parvovirus-like hybrid genome traced to nucleic acid extraction spin columns. J Virol 2013 Nov;87(22):11966-77.
Stewart H, Walter C, Jones D, Lyons S, Simmonds P, Harris M. The non-primate hepacivirus 5' untranslated region possesses internal ribosomal entry site activity. J Gen Virol 2013 Dec;94(Pt 12):2657-2663.
Lauck M, Sibley SD, Lara J, Purdy MA, Khudyakov Y, Hyeroba D, Tumukunde A, Weny G, Switzer WM, Chapman CA, Hughes AL, Friedrich TC, O'Connor DH, Goldberg TL. A novel hepacivirus with an unusually long and intrinsically disordered NS5A protein in a wild Old World primate. J Virol 2013 Aug;87(16):8971-81.
Ruby JG, Bellare P, Derisi JL. PRICE: software for the targeted assembly of components of (Meta) genomic sequence data. G3 (Bethesda) 2013 May 20;3(5):865-80.