Fig. 1: HVR insertions in a HEV patient identified by clonal sequencing.

a The treatment course of a chronically HEV-infected solid organ recipient is shown. The solid black line indicates the viral titer as copies/mL, while the grey lines visualize the liver enzyme levels IU/mL. The treatment period with ribavirin is indicated by the bar above. The arrow highlights the time point used for clonal sequencing. b The distribution of HVR rearrangements identified in HEV-positive colonies is shown. Depicted is the origin of inserted sequences (genes TRIM22, SERPINA1, and HEV HVR duplication) and their frequency as a percentage. Source data are provided in the Source Data file. c Maximum likelihood tree of amplicon-based clonal sequencing derived variants. Insertion-carrying clones are depicted in cyan (TRIM22), green (SERPINA1), and brown (duplication). Sequences of engineered in vitro clones representing respective clusters are depicted as orange triangles. The scale bar indicates the average number of substitutions per site. d The insertion site as well as their similarity (dots) to the strain Kernow-C1-p1 are shown. Mismatches to the reference are indicated by the used amino acid as a single letter code. The inserted amino acid sequence is indicated below. The name of the constructs is indicated in front of each row. Black boxes refer to duplicated sequence snippets.