RT Journal Article SR Electronic T1 Human cytomegalovirus genomes sequenced directly from clinical material: variation, multiple-strain infection, recombination and mutation JF bioRxiv FD Cold Spring Harbor Laboratory SP 505735 DO 10.1101/505735 A1 Nicolás M. Suárez A1 Gavin S. Wilkie A1 Elias Hage A1 Salvatore Camiolo A1 Marylouisa Holton A1 Joseph Hughes A1 Maha Maabar A1 Vattipally B. Sreenu A1 Akshay Dhingra A1 Ursula A. Gompels A1 Gavin W. G. Wilkinson A1 Fausto Baldanti A1 Milena Furione A1 Daniele Lilleri A1 Alessia Arossa A1 Tina Ganzenmueller A1 Giuseppe Gerna A1 Petr Hubáček A1 Thomas F. Schulz A1 Dana Wolf A1 Maurizio Zavattoni A1 Andrew J. Davison YR 2018 UL http://biorxiv.org/content/early/2018/12/23/505735.abstract AB The genomic characteristics of human cytomegalovirus (HCMV) strains sequenced directly from clinical material were investigated, focusing on variation, multiple-strain infection, recombination and natural mutation. A total of 207 datasets generated in this and other studies using target enrichment and high-throughput sequencing were analysed, in the process facilitating the determination of genome sequences for 91 strains. Key findings were that (i) it is vital to monitor sequence data quality, especially when analysing intrahost diversity, (ii) intrahost diversity in single-strain infections is much less than that in multiple strain infections, (iii) many recombinant strains have been generated and transmitted during HCMV evolution, and some have survived for thousands of years without further recombination, (iv) mutants lacking gene functions have been circulating and recombining for long periods and can cause congenital infection and resulting clinical sequelae. Future studies in general populations are likely to continue illuminating the evolution, epidemiology and pathogenesis of HCMV.