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

Finally, the role of HIV-1 self was investigated. Remarkably, although not significant, HIV-1 RNA was detected more in stool samples in patients where no enteropathogen could be found compared to the group with enteropathogen. This result indicates that shedding of HIV-1 in feces is not the direct result of damage to the mucosal barrier by enteropathogens, but that HIV-1 itself may damage the mucosal barrier and cause diarrhoea. Detection of HIV-1 in stool was not related to the stage of HIV-1 disease since CD4 cell count, CDC stage, and HIV-1 viral load did not differ significantly between diarrhoea patients with enteropathogen and people without enteropathogen (data not shown). The relatively low number of patients with unexplained diarrhoea is a limitation of our study. In the future, a study focusing on unexplained diarrhoea should include more HIV-1 positive patients with unexplained diarrhoea to be able to confirm our hypothesis that HIV-1 itself plays a role in gastrointestinal disorders.