Unexplained diarrhoea in HIV-1 infected individuals

BMC Infectious Diseases

Lia van der Hoek⁵  Cees JA Sol¹  Fransje Snijders³  Matthew Cotten⁴  Kevin Chung⁵  Formijn J van Hemert⁵  Richard Molenkamp¹  Sjoerd Rebers¹  Maarten F Jebbink⁵  Michel de Vries²  Martin Deijs⁵  Marta Canuti⁵  Bas B Oude Munnink⁵ 

[1]Laboratory of Clinical Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands

[2]CBS-KNAW Fungal Biodiversity Center, Utrecht, The Netherlands

[3]Beatrix Hospital, Gorinchem, The Netherlands

[4]Wellcome Trust Sanger Institute, Hinxton, CB10 1SA, UK

[5]Laboratory of Experimental Virology, Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands

关键词: Sapovirus;    Norovirus;    NonA-nonB hepatitis virus;    Immunodeficiency-associated stool virus;    Cosavirus;    Human gyrovirus;    Aichi virus;    VIDISCA-454;    HIV-1;    Diarrhoea;   

Others  :  1135003
DOI  :  10.1186/1471-2334-14-22

 received in 2013-05-17, accepted in 2014-01-08,  发布年份 2014

【 摘 要 】

Background

Gastrointestinal symptoms, in particular diarrhoea, are common in non-treated HIV-1 infected individuals. Although various enteric pathogens have been implicated, the aetiology of diarrhoea remains unexplained in a large proportion of HIV-1 infected patients. Our aim is to identify the cause of diarrhoea for patients that remain negative in routine diagnostics.

Methods

In this study stool samples of 196 HIV-1 infected persons, including 29 persons with diarrhoea, were examined for enteropathogens and HIV-1. A search for unknown and unexpected viruses was performed using virus discovery cDNA-AFLP combined with Roche-454 sequencing (VIDISCA-454).

Results

HIV-1 RNA was detected in stool of 19 patients with diarrhoea (66%) compared to 75 patients (45%) without diarrhoea. In 19 of the 29 diarrhoea cases a known enteropathogen could be identified (66%). Next to these known causative agents, a range of recently identified viruses was identified via VIDISCA-454: cosavirus, Aichi virus, human gyrovirus, and non-A non-B hepatitis virus. Moreover, a novel virus was detected which was named immunodeficiency-associated stool virus (IASvirus). However, PCR based screening for these viruses showed that none of these novel viruses was associated with diarrhoea. Notably, among the 34% enteropathogen-negative cases, HIV-1 RNA shedding in stool was more frequently observed (80%) compared to enteropathogen-positive cases (47%), indicating that HIV-1 itself is the most likely candidate to be involved in diarrhoea.

Conclusion

Unexplained diarrhoea in HIV-1 infected patients is probably not caused by recently described or previously unknown pathogens, but it is more likely that HIV-1 itself plays a role in intestinal mucosal abnormalities which leads to diarrhoea.

【 授权许可】

   
2014 Oude Munnink et al.; licensee BioMed Central Ltd.

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