Unexplained diarrhoea in HIV-1 infected individuals

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• 作者：Bas B Oude Munnink (5)
  Marta Canuti (5)
  Martin Deijs (5)
  Michel de Vries (6)
  Maarten F Jebbink (5)
  Sjoerd Rebers (7)
  Richard Molenkamp (7)
  Formijn J van Hemert (5)
  Kevin Chung (5)
  Matthew Cotten (8)
  Fransje Snijders (9)
  Cees JA Sol (7)
  Lia van der Hoek (5)
  
  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
  6. CBS-KNAW Fungal Biodiversity Center ; Utrecht ; The Netherlands
  7. 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
  8. Wellcome Trust Sanger Institute ; Hinxton ; CB10 1SA ; UK
  9. Beatrix Hospital ; Gorinchem ; The Netherlands
  
• 关键词：Diarrhoea ; HIV ; 1 ; VIDISCA ; 454 ; Aichi virus ; Human gyrovirus ; Cosavirus ; Immunodeficiency ; associated stool virus ; NonA ; nonB hepatitis virus ; Norovirus ; Sapovirus
• 刊名：BMC Infectious Diseases
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：311 KB
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  48. The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2334/14/22/prepub
  
• 刊物主题：Infectious Diseases; Parasitology; Medical Microbiology; Tropical Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2334

文摘

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.