Unexplained diarrhoea in HIV-1 infected individuals

Oude Munnink, B. B. et al. (2014) Unexplained diarrhoea in HIV-1 infected individuals. BMC Infectious Diseases, 14, 22. (doi: 10.1186/1471-2334-14-22) (PMID:24410947) (PMCID:PMC3925291)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cotten, Professor Matthew
• Authors: Oude Munnink, B. B., Canuti, M., Deijs, M., de Vries, M., Jebbink, M. F., Rebers, S., Molenkamp, R., van Hemert, F. J., Chung, K., Cotten, M., Snijders, F., Sol, C. J.A., and van der Hoek, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Virus Research
• Journal Name: BMC Infectious Diseases
• Publisher: BioMed Central
• ISSN: 1471-2334
• ISSN (Online): 1471-2334
• Copyright Holders: Copyright © 2014 Oude Munnink et al.
• First Published: First published in BMC Infectious Diseases 14: 22
• Publisher Policy: Reproduced under a Creative Commons License