Adenovirus colitis in the acquired immunodeficiency syndrome

Department of Medicine, Veterans Affairs Medical Center, University of Minnesota School of Medicine, Minneapolis.
Gastroenterology (Impact Factor: 16.72). 05/1991; 100(4):976-9.
Source: PubMed


Adenovirus was identified in colonic tissue by transmission electron microscopy or culture in 5 of 67 (7.4%) homosexual men seropositive for human immunodeficiency virus (51 with the acquired immunodeficiency syndrome) with diarrhea. Colonoscopy showed the mucosa to be normal in 3 cases and mildly inflamed in 2. Light microscopy showed foci of mucosal necrosis that contained chronic inflammatory cells and degenerating and necrotic epithelial cells with amphophilic nuclear inclusions. By transmission electron microscopy, hexagonal viral particles characteristic of adenovirus were identified within the inclusions. Only 1 patient was concomitantly infected by a second potential enteric pathogen. It was concluded that adenovirus, an uncommon enteric pathogen in immunocompetent adults, causes intestinal pathology and may be associated with diarrheal illness in persons with the acquired immunodeficiency syndrome.

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    • "The observation that enteric viruses tend to be more frequently seen in the more advanced stages of HIV infection corroborates results from previous studies comprising different viruses [Cunningham et al., 1988; Kaljot et al., 1989; Jannoff et al., 1991; Thea et al., 1993; Durepaire et al., 1995; Khoo et al., 1995; Schmidt et al., 1996]. This tendency has been observed regardless of an absent or a positive association between virus excretion and diarrhea, and may reflect the superinfections characteristic of late HIV disease stages. "
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    ABSTRACT: The prevalence of enteric viruses associated with gastroenteritis was determined in 125 stool samples from patients infected with the human immunodeficiency virus (HIV), with or without diarrhea. Diagnostic assays included enzyme immunoassays for the identification of rotavirus, adenovirus, and Norwalk virus; polyacrylamide gel electrophoresis for atypical rotaviruses and picobirnaviruses and polymerase chain reaction for astrovirus. Enteric viruses were detected in 6.4% (8 of 125) of the stools collected: five (4.0%) samples positive for adenoviruses, and three (2.3%) samples positive for picobirnaviruses were detected. No rotavirus, astrovirus, or Norwalk virus were observed. Only one of the viruses identified (adenovirus) was found in a sample from a patient with diarrhea. Viruses were detected in 10% of the patients with AIDS, 14% of the symptomatic patients, and none of the asymptomatic persons. These results do not support a major role for enteric viruses in the diarrhea suffered by HIV-infected patients.
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