Persistent diarrhea and fecal shedding of retroviral nucleic acids in children infected with human immunodeficiency virus

The human immunodeficiency virus (HIV) multiplies in lymphocytes, a type of immune cell, and macrophages, a type of defense cell. Infection with HIV causes AIDS. Although several symptoms of HIV infection result from impairment of the immune system, HIV disease may also involve other organ systems, such as the gastrointestinal tract. HIV-infected patients may develop severe diarrhea, impaired absorption of nutrients, perforation or ulcer formation in the intestines, inflammation of the esophagus, or chronic abdominal pain. Gastrointestinal complications of HIV disease in children can result in nutritional deficiency and worsening of immune abnormalities. Direct infection of gastrointestinal cells by HIV may be indicated by fecal shedding, or the presence of the virus in the feces. The fecal shedding of HIV may increase the risk of HIV transmission in the environment or by the fecal-oral route. The role of HIV infection of gastrointestinal cells was assessed by detection of HIV nucleic acids in the feces of HIV-infected children with gastrointestinal symptoms. The nucleic acid known as ribonucleic acid (RNA) was collected from the feces and converted to DNA by the enzyme reverse transcriptase. The DNA was then amplified, or copied several times, to produce quantities sufficient for identification and analysis. HIV nucleic acids were detected in the feces of HIV-infected children with and without diarrhea. However, the nucleic acids of HIV were not detected in the feces of children without HIV disease. These findings suggest that HIV infection of gastrointestinal cells may contribute to the development of gastrointestinal complications of HIV disease in children. The fecal shedding of HIV has important implications about the spreading of HIV in the environment. (Consumer Summary produced by Reliance Medical Information, Inc.)