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PMID: 8236386 Published · ppublish English Journal Article Research Support, U.S. Gov't, P.H.S.

Prevalence of enteric viruses among hospital patients with AIDS in Kinshasa, Zaire.

Transactions of the Royal Society of Tropical Medicine and Hygiene ·Vol. 87 ·No. 3 ·1993-00-00 ·Pages 263-6

Thea DM, Glass R, Grohmann GS, Perriens J, Ngoy B, Kapita B, Atido U, Mabaluku M, Keusch GT

Abstract

Diarrhoea is the most common manifestation of acquired immunodeficiency syndrome (AIDS) in Africa. Numerous parasitic or bacterial agents have been implicated, but a pathogen-specific aetiology has not been found. Enteric viruses (i.e., rotavirus, small round structured viruses, coronavirus, and adenovirus) were detected by enzyme-linked immunosorbent assay or electron microscopy in faecal specimens of 17% of 198 consecutive adult admissions to a general medical ward of an urban hospital in Kinshasa, Zaire. Overall, 57% of patients were seropositive for infection with human immunodeficiency virus (HIV) 1; of these, 50% were classified as World Health Organization AIDS stage IV. The prevalence of enteric viruses in stool specimens did not differ significantly between patients with and without HIV infection, and was not associated with acute or chronic diarrhoea, or constitutional symptoms. However, a trend (P = 0.14) towards greater frequency of virus in stools from patients in the lower 3 quintiles of the CD4/CD8 T cell ratio was seen. This trend approached statistical significance (P = 0.07) with stratification by HIV infection. Although we found no evidence in this population to support a major pathogenic role for these viruses alone in the enteropathy of AIDS, increased viral shedding was weakly associated with immunodeficiency.

Keywords
Acquired Immunodeficiency Syndrome Africa Africa South Of The Sahara Biology Demographic Factors Developing Countries Diarrhea--etiology Diseases Examinations And Diagnoses French Speaking Africa Hiv Infections Hiv Serodiagnosis Immunity Immunologic Factors Laboratory Examinations And Diagnoses Middle Africa Physiology Population Population Characteristics Research Report Urban Population Viral Diseases Zaire
MeSH Terms
Acquired Immunodeficiency Syndrome/complications,epidemiology Adenoviruses, Human/isolation & purification Coronaviridae/isolation & purification Democratic Republic of the Congo/epidemiology Diarrhea/epidemiology,microbiology Enzyme-Linked Immunosorbent Assay Feces/microbiology Female Humans Male Prevalence Rotavirus/isolation & purification
Authors & Affiliations
9 authors, click to expand affiliations / ORCID
Thea D M
International Co-operation in AIDS Research (ICAR) Unit, Project SIDA, Mama Yemo Hospital, Kinshasa, Zaire.
Glass R
Grohmann G S
Perriens J
Ngoy B
Kapita B
Atido U
Mabaluku M
Keusch G T
Other Abstracts
eng

During July-October 1989 in Zaire, a physician examined and took blood and stool samples from 198 adult patients at Mama Yemo Hospital in central Kinshasa to learn the prevalence of enteric viruses and their link to diarrhea, immunosuppression, and wasting among HIV infected and uninfected patients. In Kinshasa, diarrhea is prevalent and heterosexual intercourse is the main mode of HIV transmission. 57.6% of the patients were infected with HIV. 50% of the HIV-positive patients had AIDS. 93% of all HIV-positive patients either had AIDS (stage IV) or advanced stage III disease. 49% of them died while in the hospital. 22% of the HIV-negative patients died while in the hospital. 17% of all adult patients studied were infected with at least 1 enteric virus, especially rotavirus. Enteric viruses were isolated from both HIV infected and uninfected patients (17% and 18%, respectively). State of immunocompromise did not significantly affect viral shedding, but fewer patients in the less immunocompromised stages shed viruses than did those in the advanced stages of immunocompromise (3 vs. 72 patients). When examining the ratio of circulating CD4 and CD8 T cells in HIV-infected patients, however, there was a trend toward greater frequency of enteric viruses (p = .07). Chronic diarrhea was significantly associated with HIV seropositivity (p 0.01), HIV stage (p .001), and CD4/CD8 T cell ratio (p .01). Acute diarrhea was not associated with any of the above, however. These findings suggest that enteric viruses were not a significant cause of diarrhea, but they were isolated somewhat more often in patients of advanced immunosuppression.

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Article Info
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene
Abbr.
Trans R Soc Trop Med Hyg
ISSN
0035-9203
Published
1993-00-00
Pages
263-6
Language
English
Region
England
NLM ID
7506129
PMCID
PMC7107222
Subset
IM
Grants
NIAID NIH HHS · P01-AI-26698 · United States
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