Rotavirus antigen detection in patients with HIV infection and diarrhea

A wide variety of bacterial, viral, and parasitic pathogens can cause severe diarrhea in patients with advanced human immunodeficiency virus (HIV) infection. The role of enteric viruses, especially rotaviruses, in HIV-related diarrhea is still unclear. One hundred and six stool samples from 66 HIV-infected patients with otherwise unexplained diarrhea and 35 samples from 35 patients with advanced HIV infection but without diarrhea were tested for the presence of rotavirus antigen. Rotavirus was detected in 13 samples from 9 patients with diarrhea and in none of the samples from patients without diarrhea. Two patients had recurrence of rotavirus infection more than 6 months after the first episode. Rotavirus was associated with prolonged diarrhea, often accompanied by abdominal cramping. Symptoms were readily controlled with anti-diarrheal and pain-relieving measures. Illness was self-limited and did not require hospitalization. A seasonal variation, typical of infantile rotavirus infection, was not observed in this setting. While rotavirus infection has been infrequently detected in American HIV-infected patients, the prevalence in Australia and Europe appears to be considerably higher.