Enteric viruses in HIV-1 seropositive and HIV-1 seronegative children with diarrheal diseases in Brazil

PLoS One. 2017 Aug 30;12(8):e0183196. doi: 10.1371/journal.pone.0183196. eCollection 2017.

Abstract

Diarrheal diseases (DD) have distinct etiological profiles in immune-deficient and immune-competent patients. This study compares detection rates, genotype distribution and viral loads of different enteric viral agents in HIV-1 seropositive (n = 200) and HIV-1 seronegative (n = 125) children hospitalized with DD in Rio de Janeiro, Brazil. Except for group A rotavirus (RVA), which were detected through enzyme immunoassay, the other enteric viruses (norovirus [NoV], astrovirus [HAstV], adenovirus [HAdV] and bocavirus [HBoV]) were detected through PCR or RT-PCR. A quantitative PCR was performed for RVA, NoV, HAstV, HAdV and HBoV. Infections with NoV (19% vs. 9.6%; p<0.001), HBoV (14% vs. 7.2%; p = 0.042) and HAdV (30.5% vs. 14.4%; p<0.001) were significantly more frequent among HIV-1 seropositive children. RVA was significantly less frequent among HIV-1 seropositive patients (6.5% vs. 20%; p<0.001). Similarly, frequency of infection with HAstV was lower among HIV-1 seropositive children (5.5% vs. 12.8%; p = 0.018). Among HIV-1 seropositive children 33 (16.5%) had co-infections, including three enteric viruses, such as NoV, HBoV and HAdV (n = 2) and NoV, HAstV and HAdV (n = 2). The frequency of infection with more than one virus was 17 (13.6%) in the HIV-1 negative group, triple infection (NoV + HAstV + HBoV) being observed in only one patient. The median viral load of HAstV in feces was significantly higher among HIV-1 positive children compared to HIV-1 negative children. Concerning children infected with RVA, NoV, HBoV and HAdV, no statistically significant differences were observed in the medians of viral loads in feces, comparing HIV-1 seropositive and HIV-1 seronegative children. Similar detection rates were observed for RVA, HAstV and HAdV, whilst NoV and HBoV were significantly more prevalent among children with CD4+ T lymphocyte count below 200 cells/mm3. Enteric viruses should be considered an important cause of DD in HIV-1 seropositive children, along with pathogens more classically associated with intestinal infections in immunocompromised hosts.

MeSH terms

  • Adenoviridae / growth & development
  • Adenoviridae / isolation & purification
  • Adenoviridae Infections / epidemiology*
  • Adenoviridae Infections / immunology
  • Adenoviridae Infections / virology
  • Astroviridae Infections / epidemiology*
  • Astroviridae Infections / immunology
  • Astroviridae Infections / virology
  • Brazil / epidemiology
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / virology
  • Caliciviridae Infections / epidemiology*
  • Caliciviridae Infections / immunology
  • Caliciviridae Infections / virology
  • Child
  • Child, Preschool
  • Coinfection
  • Diarrhea / epidemiology*
  • Diarrhea / immunology
  • Diarrhea / virology
  • Feces / virology
  • Female
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / immunology
  • Gastroenteritis / virology
  • HIV Infections / epidemiology*
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV-1 / growth & development
  • HIV-1 / isolation & purification
  • Human bocavirus / growth & development
  • Human bocavirus / isolation & purification
  • Humans
  • Infant
  • Male
  • Mamastrovirus / growth & development
  • Mamastrovirus / isolation & purification
  • Norovirus / growth & development
  • Norovirus / isolation & purification
  • Parvoviridae Infections / epidemiology*
  • Parvoviridae Infections / immunology
  • Parvoviridae Infections / virology
  • Prevalence
  • Rotavirus / growth & development
  • Rotavirus / isolation & purification
  • Rotavirus Infections / epidemiology*
  • Rotavirus Infections / immunology
  • Rotavirus Infections / virology
  • Viral Load

Grants and funding

This study was sponsored by Oswaldo Cruz Institute/Fiocruz, National Council for Scientific and Technological Development (PAPES VI/Fiocruz-CNPq-407566), PAEF/Fiocruz (IOC008-FIO-15-71), Coordination for Improvement of Higher Level Personnel (CAPES) and Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ- E-26/202.968/2015). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.