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

Several viruses known to cause diarrhoea were found: sapovirus, enterovirus and norovirus (see Table 3 ). Furthermore, new candidate diarrhoea viruses were detected: human gyrovirus, cosavirus, and Aichi virus. In addition, known viruses of which it is not likely that they are involved in diarrhoea were detected: human adenovirus D viruses (type 23, 45 and 51, types which are not associated with diarrhoea), JC polyoma virus (probably originating from urine [41] ), hepatitis B virus, rhinovirus (probably originating from respiratory tract) and human papilloma viruses. Furthermore torque teno viruses (TTV) and picobirnaviruses were found. TTVs represent an extremely diverse set of viruses which can differ substantially in their genome sequence and the size of their genome. These viruses have been detected in a large variety of clinical samples, and their association with any disease has not been established thus far [42] . Also picobirnaviruses are exceptionally diverse, they have been detected in diarrhoea patients, however, during outbreaks a diverse swarm of picobirnaviruses is observed making it less likely that these viruses cause diarrhoea [43] . Interestingly, a high amount of sequences of Cryptosporidium parvum-virus was found in a patient infected with Cryptosporidium parvum. Detection of this virus in stool of a patient never has been reported, although it has been suggested to perform screening for the presence of this virus in environmental samples to determine if water is infected with the parasite [44] .