HIV-1 seroprevalence in Zambian patients with acute diarrhea: A community-based study

The seroprevalence of HIV-I in sub-Saharan African patients with diarrhea i n the community remains largely unknown. We present the findings of a 2-mon th that we undertook to ascertain the seroprevalence of HIV-1 in Zambian pa tients presenting with acute diarrhea in a community-based health center. A total of 256 patients with diarrhea and 140 apparently healthy controls wa s seen. Of the patients with diarrhea, 161 were <16 years old and 95 were a dults. Most children with diarrhea. were <6 years old (147 of 161; 91%). Ov erall, 81 of 256 (32%) patients with diarrhea were HIV-1-seropositive. When results from children <18 months old and possibly having maternal anti-HIV -1 antibodies were excluded, 64 of 172 (37%) patients with diarrhea were HI V-seropositive. Rates of HIV-I seropositivity for patients with diarrhea we re significantly higher than were rates for diarrhea-free controls (p < .00 1 for both the total population; odds ratio [OR], 95% confidence interval [ CI], 1.42 < 2.48 population >18 months old (OR, 95% CII 1.54 < 2.90 < 5.49) . Among children between 18 months and 5 years old, 14 fo 63 (22%) were HIV -1-seropositive compared with 8 of 62 (13%) without diarrhea (P > .05, not significant). Moreover, 49 of 95 (52%) adults with acute diarrhea were HIV- 1-seropositive compared with 10 of 44 (23%) healthy adult controls (p < .00 3; OR, 95% CI, 1.51 < 3.62 < 8.87). No significant differences were found i n HIV-1 seroprevalence rates between males and females in all age groups. T hese data show a close association between acute diarrhea and HIV seroposit ivity in Zambian adults in the community.