Enteric Virus Infections and Diarrhea in Healthy and Human Immunodeficiency Virus-Infected Children

TLDR

Stool samples from 27 HIV‑positive and 38 HIV‑negative children were collected over 15 months and screened for rotavirus, adenovirus, Norwalk virus, picobirnavirus, atypical rotavirus, astrovirus, and enterovirus using enzyme immunoassays, gel electrophoresis, and PCR. HIV‑positive children had higher enterovirus (56 % vs 21 %) and astrovirus (12 % vs 0 %) rates, but similar rotavirus prevalence and diarrhea incidence to HIV‑negative peers, with enterovirus shedding lasting up to six months and no evidence of prolonged poliovirus vaccine excretion, indicating enteric viruses are unlikely to cause the frequent diarrhea in these children.

Abstract

ABSTRACT Forty-three stool samples from 27 human immunodeficiency virus (HIV)-seropositive children and 38 samples from 38 HIV-negative children, collected during a 15-month period, were examined for enteric viruses. Diagnostic assays included enzyme immunoassays for rotavirus, adenovirus, and Norwalk virus; polyacrylamide gel electrophoresis for picobirnavirus and atypical rotavirus; and PCR for astrovirus and enterovirus. Specimens from HIV-positive children were more likely than those of HIV-negative children to have enterovirus (56 versus 21%; P < 0.0002) and astrovirus (12 versus 0%; P < 0.02), but not rotavirus (5 versus 8%; P > 0.5). No adenoviruses, picobirnaviruses, or Norwalk viruses were found. The rates of virus-associated diarrhea were similar among HIV-positive and HIV-negative children. Enteroviruses were excreted for up to 6 months in HIV-positive children; however, no evidence for prolonged excretion of poliovirus vaccine was observed. These results suggest that although infection with enterovirus and astrovirus may be frequent in HIV-infected children, enteric viruses are not associated with the diarrhea frequently suffered by these children.