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The sequence of NP1 gene is conserved and had 98%–100% nt identities among the Sri Lanka strains. However, our study demonstrates that HBo V also can be detected in well-nourished children and adults with encephalitis. HBo V viremia has been documented, and the virus might therefore have the potential to cross the blood–brain barrier.

The NP1 of HBo V inhibits interferon-β production by the host, suggesting evasion of the innate immune response during infection (), all patients in our study recovered.

The Sri Lanka HBo V1 strains had 98%–99% nt identities among themselves and with other HBo V1 strains.

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In addition to HBo V1 and HBo V2, we detected HBo V3 in a child with encephalitis, which to our knowledge, has not been reported as a cause of the disease.

Although HBo V infections occur mainly in children, among the 5 Sri Lanka patients with HBo V encephalitis, 3 were adults or adolescents.

The causes of encephalitis were type 2 dengue virus in 1 (0.5%) patient, human echovirus (HEco V) type 9 or 25 in 2 (1%), HBo V (Table) in 5 (3%), and HAd V 41 in 7 (4%): all were sole detections.

None of the other viruses and no bacteria were detected.

The ethics committees of the University of Kelaniya and Oita University approved this study.

CSF samples were subjected to macroscopic examination, total and differential leukocyte counts, bacterial culture, Gram staining, and measurement of protein and glucose.

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Clinical and laboratory information was available for 164 patients.

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