| Objective Genotyping of varicella-zoster virus (VZV) strains isolated from patients with varicella or zoster and differentiating them from Oka vaccine strain by molecular analysis. Identify possible vaccine adverse reactions in varicella or zoster patients.Methods In the present study, VZVs were isolated from skin lesions of varicella or zoster patients in the Dermatology Clinic of the First Affiliated Hospital of Anhui Medical University and were genotyped by analyzing DNA sequence variation in open reading frames (ORFs) 1, 21, 22, 31, 37, 54, 60, 62, 67, 68 along with an evaluation of three well-characterized single nucleotide polymorphisms (SNPs) in ORFs 6, 38, 54, and 62 by restriction fragment length polymorphism (RFLP) analysis. Concatenated sequences (ORFs1, 31, 37, 60, 62, 67, 68) of China VZV isolates and reference strains were aligned by MEGA 4.02 and used for phylogenetic analysis. The phylogenetic tree was verified using the neighbor joining (MEGA 4.02; model: Tamura-Nei; bootstrap analysis: 10,000 replicates) methods. Analysis the genomic variations of the vaccine-like strain based on vaccine strain-associated markers to detected possible attenuated virus infections.Results Forty four strains were isolated from 61 cases of herpes zoster or varicella and were confirmed by immunofluorescence with anti-VZV gE and IE62 monoclonal antibody. The restriction fragment length polymorphism (RFLP) analysis of the isolates include there different groups with 42 (96%) of AluI-PstI+BglI+SmaI-NaeI-BssHII-, 1 (2%) of AluI-PstI-BglI+ SmaI-NaeI-BssHII- and 1 (2%) of AluI+PstI-BglI+ SmaI+NaeI+BssHII+ which is very different from those found in North America, Europe and Japan. Based on the analysis of 97 polymorphic markers in the 10 open reading frames, all of the 44 isolates can be placed genotype J by the SNP profile in VZV ORF22, or clade B based on the SNP profiles in ORFs 31, 37, 60, 62, 67 and 68. Forty-three isolates were belong to genotype J1 and one isolate to genotype J2 by the SNP profiles in ORFs 1, 21, 22 and 54. A novel synonymous A>G SNP in ORF 60 was found in 4 (9.1%) of the isolates. The three consecutive nucleotide (CGG) in-frame insertions in ORF 1 were found in 8 (18.2%) isolates, which has not been described in VZV strains from any other part of the world. In addition, a previously described three consecutive nucleotide (ATC) insertion in ORF 60 was found in all the isolates. The results of phylogenetic analysis suggested that the 44 Chinese isolates may consist of four clusters.Conclusion VZV isolates obtained in Hefei China showed different molecular characteristics and significantly higher genetic homogenicity than isolates from those circulating in Europe and North America. Nevertheless, genetic variations are still present in those strains, may be differentiated that were associated with SNPs and insertions which may be used as markers in epidemiological surveillance. PstI- strain is also circulating in China and v-Oka strain was isolated from a pregnant woman with mild varicella, which represents the first vaccine strain found in a patient with varicella in China.
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