Shorter survival in HIV-positive patients with diarrhoea who excrete adenovirus from the GI tract

Adenoviruses have been described as a cause of diarrhoea in patients infect ed with the human immunodeficiency virus (HIV). The prevalence of adenoviru ses was studied in all HIV-positive patients presenting with diarrhoea at t he Royal Free Hospital in London between 1991 and 1995. in addition, all po stmortems carried out in HIV-positive individuals registered at the same ce ntre between 1990 and 1997 were reviewed for evidence of adenovirus infecti on. Adenovirus was detected in 16.1% of patients presenting with diarrhoea. These individuals had a significantly lower CD4 count and were more likely to have had a diagnosis of acquired immunodeficiency syndrome (AIDS) than patients with diarrhoea in whom adenovirus was not detected. The median sur vival was 1 year compared with 2.4 years for those without adenoviruses; th is difference remained significant (P = .008) after controlling for differe nces in CD4 counts between the groups. Gastrointestinal adenovirus excretio n occurs at an advanced stage of HIV disease, and is associated with a poor prognosis. We suggest that adenoviruses may contribute to mortality in thi s population. (C) 1999 Wiley-Liss, Inc.