Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Ethics Statement
2.3. Specimen Collection, Handling and Storage
2.4. Viral Nucleic Acid Extraction
2.5. Detection of Enteroviruses and Other Viral Enteric Co-Infections
2.6. VP1 Amplification, Sequencing and Molecular Typing
2.7. Statistical Analysis
3. Results
3.1. Characteristics of Enterovirus-positive and Negative Participants
3.2. Enterovirus Typing
3.3. Co-Infection with Other Enteric Viruses
3.4. Factors Associated with CD4+ T Cell Count in HIV-Positive Participants With and Without Enterovirus Co-Infection
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Parameters | Total (n = 352) | Enterovirus-Positive Subjects (n = 40, 11.4%) | Enterovirus-Negative Subjects (n = 312, 88.6%) | p-Value |
---|---|---|---|---|
Age in years, mean ± SD: | 38.2 ± 10.6 | 37.7 ± 10.7 | 38.3 ± 10.6 | 0.760 |
in HIV-positive subjects | 40.3 ± 9.1 | 42.3 ± 9.2 | 40.0 ± 9.1 | 0.186 |
in HIV-negative subjects | 32.9 ± 12.3 | 28.6 ± 6.4 | 33.6 ± 12.9 | 0.029 |
Female gender, n (%) | 247 (70.6) | 31 (77.5) | 216 (69.7) | 0.307 |
HIV status: | ||||
positive, n (%) | 250 (71.0) | 26 (65.0) | 224 (71.8) | 0.372 |
negative, n (%) | 102 (29.0) | 14 (35.0) | 88 (28.2) | |
CD4+ T cells/μL (IQR): | ||||
in HIV-positive subjects | 221 (87–474) | 416 (168–535) | 204 (78–460) | 0.017 |
in HIV-negative subjects | 969 (786–1150) | 958 (769–1038) | 982 (787–1153) | 0.726 |
Low BMI (<18.5 kg/m²), n (%): | 37 (11.1) | 1 (2.7) | 36 (12.2) | 0.099 |
in HIV-positive subjects | 34 (13.9) | 1 (3.8) | 33 (15.1) | 0.143 |
in HIV-negative subjects | 3 (3.4) | 0 (0.0) | 3 (3.9) | 1.00 |
Clinical symptoms during last 6 months: | ||||
Gastrointestinal symptoms, n (%) | 64 (18.4) | 8 (20.0) | 56 (18.2) | 0.780 |
Feverish symptoms, n (%) | 42 (18.5) | 5 (18.5) | 37 (18.5) | 0.998 |
Cough, n (%) | 56 (16.1) | 7 (17.5) | 49 (15.9) | 0.797 |
Skin rashes, n (%) | 26 (7.5) | 3 (7.5) | 23 (7.5) | 1.000 |
Access to tap water, n (%) | 190 (54.6) | 21 (52.5) | 169 (54.9) | 0.777 |
Fridge/freezer in household, n (%) | 249 (71.6) | 30 (75.0) | 219 (71.1) | 0.607 |
Electricity in household, n (%) | 326 (93.7) | 40 (100.0) | 286 (92.9) | 0.091 |
ID | HIV Status | Sex | Age in Years | CD4+ T Cells/μl | On ART | Feverish Symptoms | Cough | Gastrointestinal Symptoms | Skin Rashes | Enterovirus Typing Result | Enterovirus Species | Other Enteric Infections |
---|---|---|---|---|---|---|---|---|---|---|---|---|
CHP012 | neg | f | 33 | NA | NA | - | - | - | - | Enterovirus C | Enterovirus C | - |
CHP013 | neg | f | 23 | 1276 | NA | - | - | - | - | CVA19 | Enterovirus C | - |
CHP021 | neg | f | 32 | 921 | NA | - | - | - | - | CVA13 | Enterovirus C | - |
CHP023 | neg | f | 28 | 940 | NA | - | - | + | - | Enterovirus C | Enterovirus C | - |
CHP027 | neg | m | 23 | 977 | NA | - | - | - | - | CVA20 | Enterovirus C | - |
CHP028 | neg | f | 29 | 735 | NA | + | + | - | - | CVA13 | Enterovirus C | - |
CHP029 | neg | f | 26 | 1698 | NA | - | - | - | - | EV-C99 | Enterovirus C | - |
CHP042 | neg | f | 33 | 967 | NA | + | - | + | + | Enterovirus C | Enterovirus C | - |
CHP051 | neg | m | 19 | 958 | NA | - | - | + | - | CVA19 | Enterovirus C | - |
CHP061 | neg | m | 22 | 1381 | NA | - | - | - | - | EV-C99 | Enterovirus C | CoSV-D |
CHP065 | neg | m | 39 | 680 | NA | - | - | - | - | Enterovirus C | Enterovirus C | - |
CHP105 | neg | f | 25 | 1038 | NA | - | - | + | + | Enterovirus C | Enterovirus C | - |
CHP138 | neg | m | 27 | 363 | NA | - | - | - | - | CVA20 | Enterovirus C | - |
CHP165 | neg | f | 41 | 769 | NA | - | + | - | - | EV-C99 | Enterovirus C | - |
HP0008 | pos | f | 55 | 65 | - | NA | - | + | - | EV-A119 | Enterovirus A | AdV, CoSV-A |
HP0010 | pos | m | 56 | 522 | + | + | - | - | - | EV-C99 | Enterovirus C | NoV G2, AdV |
HP0038 | pos | m | 38 | 396 | + | NA | - | - | - | CVA5 | Enterovirus A | - |
HP0063 | pos | f | 40 | 470 | + | NA | - | - | - | EV-C99 | Enterovirus C | - |
HP0120 | pos | f | 50 | 331 | - | NA | - | - | - | CVA20 | Enterovirus C | - |
HP0123 | pos | f | 28 | 134 | - | NA | - | - | - | CVA17 | Enterovirus C | AdV |
HP0130 | pos | f | 30 | 465 | - | NA | - | - | - | Enterovirus C | Enterovirus C | - |
HP0210 | pos | f | 48 | 356 | - | + | - | - | - | E27 | Enterovirus B | NoV GI |
HP0216 | pos | m | 43 | 851 | - | NA | - | - | - | EV-C113 | Enterovirus C | - |
HP0255 | pos | f | 26 | 455 | - | NA | - | - | - | EV-C113 | Enterovirus C | - |
HP0274 | pos | f | 43 | 539 | + | NA | + | - | - | CVA20 | Enterovirus C | AdV |
HP0297 | pos | f | 36 | 655 | + | NA | + | + | - | EV-B74 | Enterovirus B | SaV |
HP0335 | pos | f | 36 | 391 | + | NA | - | - | - | EV-C113 | Enterovirus C | SaV |
HP0361 | pos | f | 27 | 725 | + | NA | - | - | - | CVA20 | Enterovirus C | - |
HP0407 | pos | f | 47 | 1677 | + | NA | - | - | - | CVA19 | Enterovirus C | - |
HP0578 | pos | f | 59 | 635 | + | - | - | - | - | CVA13 | Enterovirus C | NoV GII |
HP0648 | pos | f | 57 | 318 | - | - | - | - | - | E14 | Enterovirus B | - |
HP0762 | pos | f | 45 | 151 | - | - | - | - | - | EV-A119 | Enterovirus A | AdV, CoSV-D |
HP0800 | pos | f | 44 | 555 | - | + | + | + | - | EV-B106 | Enterovirus B | AdV |
HP0845 | pos | m | 39 | 93 | - | - | - | - | - | CVB6 | Enterovirus B | CoSV-D |
HP0916 | pos | f | 38 | 181 | + | - | - | - | - | CVA20 | Enterovirus C | - |
HP0932 | pos | f | 51 | 83 | - | - | + | + | + | EV-A76 | Enterovirus A | CoSV-B |
HP0995 | pos | f | 37 | 435 | + | - | + | - | - | CVA13 | Enterovirus C | SaV, CoSV-D |
HP1007 | pos | f | 47 | 87 | + | - | - | - | - | EV-A119 | Enterovirus A | NoV GII2, AdV |
HP1097 | pos | f | 40 | 163 | - | - | - | - | - | Positive | NA | - |
HP1107 | pos | f | 48 | 466 | - | - | - | - | - | EV-C99 | Enterovirus C | - |
HIV-Positive With and Without Enterovirus Co-Infection | ||||
---|---|---|---|---|
Simple Linear Regression Models | Multiple Linear Regression Model | |||
Variable | β-Coef | p Value | β-Coef | p Value |
Age in years | 4.12 | 0.077 | 3.91 | 0.073 |
Male | −41.74 | 0.381 | −28.65 | 0.517 |
ART intake | 275.13 | <0.001 | 262.09 | <0.001 |
Enterovirus species compared to enterovirus-negative status | ||||
Enterovirus A | −160.03 | 0.287 | −199.38 | 0.152 |
Enterovirus B | 78.975 | 0.599 | 101.43 | 0.465 |
Enterovirus C | 235.37 | 0.008 | 167.77 | 0.042 |
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Di Cristanziano, V.; Weimer, K.; Böttcher, S.; Sarfo, F.S.; Dompreh, A.; Cesar, L.-G.; Knops, E.; Heger, E.; Wirtz, M.; Kaiser, R.; et al. Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana. Viruses 2020, 12, 221. https://doi.org/10.3390/v12020221
Di Cristanziano V, Weimer K, Böttcher S, Sarfo FS, Dompreh A, Cesar L-G, Knops E, Heger E, Wirtz M, Kaiser R, et al. Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana. Viruses. 2020; 12(2):221. https://doi.org/10.3390/v12020221
Chicago/Turabian StyleDi Cristanziano, Veronica, Kristina Weimer, Sindy Böttcher, Fred Stephen Sarfo, Albert Dompreh, Lucio-Garcia Cesar, Elena Knops, Eva Heger, Maike Wirtz, Rolf Kaiser, and et al. 2020. "Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana" Viruses 12, no. 2: 221. https://doi.org/10.3390/v12020221