PREVALENCE OF ENTERIC VIRUSES AMONG HOSPITAL PATIENTS WITH AIDS IN KINSHASA, ZAIRE

Diarrhoea is the most common manifestation of acquired immunodeficienc y syndrome (AIDS) in Africa. Numerous parasitic or bacterial agents ha ve been implicated, but a pathogen-specific aetiology has not been fou nd. Enteric viruses (i.e., rotavirus, small round structured viruses, coronavirus, and adenovirus) were detected by enzyme-linked immunosorb ent assay or electron microscopy in faecal specimens of 17% of 198 con secutive adult admissions to a general medical ward of an urban hospit al in Kinshasa, Zaire. Overall, 57% of patients were seropositive for infection with human immunodeficiency virus (HIV) 1; of these, 50% wer e classified as World Health Organization AIDS stage IV. The prevalenc e of enteric viruses in stool specimens did not differ significantly b etween patients with and without HIV infection, and was not associated with acute or chronic diarrhoea, or constitutional symptoms. However, a trend (P=0.14) towards greater frequency of virus in stools from pa tients in the lower 3 quintiles of the CD4/CD8 T cell ratio was seen. This trend approached statistical significance (P=0.07) with stratific ation by HIV infection. Although we found no evidence in this populati on to support a major pathogenic role for these viruses alone in the e nteropathy of AIDS, increased viral shedding was weakly associated wit h immunodeficiency.