Unexplained diarrhoea in HIV-1 infected individuals

Oude Munnink, Bas B; Canuti, Marta; Deijs, Martin; de Vries, Michel; Jebbink, Maarten F; Rebers, Sjoerd; Molenkamp, Richard; van Hemert, Formijn J; Chung, Kevin; Cotten, Matthew; Snijders, Fransje; Sol, Cees JA; van der Hoek, Lia

One of the recently described gastrointestinal viruses is cosavirus, which was identified in 2008 as a member of the Picornaviridae [14] . The virus was originally found in 2 patients with gastrointestinal infections [14, 15] . However, its link with diarrhoea has not been established and a recent study in HIV-infected individuals detected cosavirus in a substantial number of patients without diarrhoea [16] . Aichi virus is another recently described picornavirus which was identified in fecal samples of patients with gastroenteritis [17] . Several manuscripts have since then confirmed that the virus is associated with diarrhoea [18, 19] , although in one study, which included children without diarrhoea, the association with disease could not be established since the amount of positive samples was too low [20] . Human gyrovirus, a member of the Circoviridae, is the most unusual novel virus which is found in gastrointestinal infections [21] . The virus is genetically very closely related to gyroviruses found in chicken meat [22] and therefore it remains uncertain whether human gyrovirus in stool is a sign of gastrointestinal infection or a virus which is digested with food and shed in feces, like many food related viruses [23] .