title: Shorter survival in HIV-positive patients with diarrhoea who excrete adenovirus from the GI tract.
abstract: Adenoviruses have been described as a cause of diarrhoea in patients infected with the human immunodeficiency virus (HIV). The prevalence of adenoviruses was studied in all HIV-positive patients presenting with diarrhoea at the Royal Free Hospital in London between 1991 and 1995. In addition, all postmortems carried out in HIV-positive individuals registered at the same centre between 1990 and 1997 were reviewed for evidence of adenovirus infection. 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 survival was 1 year compared with 2.4 years for those without adenoviruses; this difference remained significant (P = .008) after controlling for differences in CD4 counts between the groups. Gastrointestinal adenovirus excretion occurs at an advanced stage of HIV disease, and is associated with a poor prognosis. We suggest that adenoviruses may contribute to mortality in this population.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, England. caroline@rfhsm.ac.uk
authors.forename: C A
authors.initials: CA
authors.lastname: Sabin
authors.forename: G S
authors.initials: GS
authors.lastname: Clewley
authors.forename: J R
authors.initials: JR
authors.lastname: Deayton
authors.forename: A
authors.initials: A
authors.lastname: Mocroft
authors.forename: M A
authors.initials: MA
authors.lastname: Johnson
authors.forename: C A
authors.initials: CA
authors.lastname: Lee
authors.forename: J E
authors.initials: JE
authors.lastname: McLaughlin
authors.forename: P D
authors.initials: PD
authors.lastname: Griffiths
mesh_terms: D000256:Adenoviridae / Q000302:isolation & purification*; D000257:Adenoviridae Infections / Q000150:complications* / Q000276:immunology / Q000401:mortality; D000328:Adult; D000368:Aged; D001344:Autopsy; D018791:CD4 Lymphocyte Count; D003967:Diarrhea / Q000209:etiology / Q000821:virology*; D004064:Digestive System / Q000821:virology*; D005243:Feces / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013997:Time Factors