HIV-1 seroprevalence in Zambian patients with acute diarrhea: A community-based study

Chronic diarrhea is a common clinical presentation of HIV infection worldwide and a major cause of mortality in cohorts of HIV-infected African children. Findings are presented from a study of HIV-1 seroprevalence among Zambian patients presenting to George Health Center a community-based health center northwest of center Lusaka with acute diarrhea during March-April 1994. 256 patients with diarrhea and 140 apparently healthy controls participated in the study. Of the patients with diarrhea 161 were under 16 years old and 95 were adults. 147 (91%) of the children with diarrhea were under age 6 years. Overall 81 of the 256 (32%) patients with diarrhea were HIV-1-seropositive. Excluding results from infants under age 18 months who may have had maternal anti-HIV-1 antibodies 64 of 172 (37%) patients with diarrhea were HIV-seropositive. Among children aged 18 months to 5 years 14 of 63 (22%) were HIV-1-seropositive compared with 8 of 62 (13%) without diarrhea. 49 of 95 adults with acute diarrhea were HIV-1-seropositive compared with 10 of 44 healthy adult controls. No significant differences were found in HIV-1 seroprevalence rates between males and females in all age groups. These data point to a close association between acute diarrhea and HIV seropositivity in this research setting.