title: Enteroviruses as a possible cause of hypertension, dilated cardiomyopathy (DCM) and hypertensive heart failure (HHF) in South western Nigeria.
abstract: BACKGROUND
  Human enteroviruses have long been associated with various diseases of man resulting into a wide range of acute symptoms involving the cardiac and skeletal muscles, central nervous system, pancreas, skin and mucous membranes.
  
  
  OBJECTIVE
  To assess the role of enteroviruses in the etiology of hypertension, DCM and HHF.
  
  
  METHODS
  We obtained stool specimens from 70 subjects comprising 65 patients and 5 controls and isolation was carried out on RD, L20B, HEp-2C and Vero cell lines and identified by neutralization with standard antisera (RIVM). Thirty-six enteroviruses were isolated and identified to be Coxsackieviruses-B5, A9, Echoviruses 1, 6, 7, 9, 11, 12, 22, 30 and Poliovirus type 1 and 3.
  
  
  RESULTS
  Three most frequently occurring enterovirus serotypes which constitute 60.0% of the 30 NPEV typed and 50.0% of all the isolates were Echoviruses, Coxsackie-B5-virus and Coxsackievirus-A9. Echoviruses constituted 50.0% of all the serotypes while Coxsackieviruses-B5 and A9 accounts for the 27.8 % and 5.6% respectively. Enteroviral isolation rate was higher in age groups 51 years and above. The percentage of study subjects who had Coxsackie-B5-viruses and echoviruses was significantly (P<0.05) higher in cases of hypertension, HHF and DCM than in control subjects. Coxackie-B5-virus, Echovirus-6 and Echovirus-11 were found in both study locations.
  
  
  CONCLUSIONS
  The findings of this study showed that Enteroviruses may likely be involved in the etiology of hypertension, DCM and HHF. Further studies would therefore be necessary for the prevention and control of these diseases.
authors.affiliation: Medical Microbiology & Virology Unit, Department of Microbiology, University of Port Harcourt, East-West Road, P.M.B. 5323, Choba, Port Harcourt, Rivers State, Nigeria.
authors.forename: I O
authors.initials: IO
authors.lastname: Okonko
authors.affiliation: Cardiology Unit, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: A A
authors.initials: AA
authors.lastname: Adebiyi
authors.affiliation: Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria.
authors.forename: O S
authors.initials: OS
authors.lastname: Ogah
authors.affiliation: Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
authors.forename: F D
authors.initials: FD
authors.lastname: Adu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004770:Enterovirus / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000150:complications* / Q000175:diagnosis; D005243:Feces / Q000821:virology; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011051:Poliomyelitis / Q000150:complications / Q000175:diagnosis; D017955:Poliovirus / Q000302:isolation & purification; D012307:Risk Factors; D012703:Serotyping
keywords: Echoviruses; Enteroviruses; Etiology; coxsackieviruses; dilated cardiomyopathy (DCM); hypertension; hypertensive heart failure (HHF)