Prevalence of adenovirus, astrovirus and rotavirus diarrhoea in children infected with human immunodeficiency virus in Nairobi, Kenya

Abstract

Diarrhoea is one of the commonest symptoms of disease in children. In some communities 25% of children younger than one year may suffer from diarrhoea episodes in any two-week period. Worldwide, each child under five years of age may suffer an average of 3 episodes of diarrhoea per year. Majority of these diarrhoeal cases are due to acute self-limiting intestinal viral infection and can be successfully managed without recourse to health services. However HIV predisposes infected persons to intestinal infection with various pathogens leading to persisting severe diarrhoea. The present study evaluated the viral causes of diarrhoea in children with HIV and compared them with children with unknown HIV status. Between February 1999 and June 2000 stool samples were collected from 113 HIV positive children and 94 samples from children with unknown HIV status suffering from diarrhoea. The samples were assayed for astrovirus, adenovirus and rotavirus, three common causes of severe diarrhoea in young children. Antiviral antibody ELISA was used to screen the three viruses, but further characterisation of rotavirus was done using SDS-PAGE, VP6 subgroup antibody ELISA, VP7 monoclonal antibody ELISA and RT-PCR for genotyping of VP7 and VP4 genes. The results showed that the incidences of adenovirus, astrovirus and rotavirus did not vary significantly in HIV infected and uninfected children. Astrovirus was also shown to be an important cause of diarrhoea in children in Kenya (5.8%). The main rotavirus genotypes in children, (G3P[6] and G8P[6]) differed from the predominant types known (G 1P[8]). This shows that the important genotype pairs that are responsible for diarrhoea in Kenya differ from those that are important in causing diarrhoea in most parts of the world. This has significant implications in vaccine development since this requires knowledge of the molecular characteristics of circulating strains within a regions population.