High detection frequency and viral loads of human rhinovirus species A to C in fecal samples; diagnostic and clinical implications

• Published in: Journal of medical virology Vol. 84; no. 3; pp. 536 - 542
• Main Authors: Harvala, H., McIntyre, C.L., McLeish, N.J., Kondracka, J., Palmer, J., Molyneaux, P., Gunson, R., Bennett, S., Templeton, K., Simmonds, P.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2012; Wiley; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Child; Child, Preschool; Diagnosis, Differential; diagnostic; enterovirus; Enterovirus - genetics; Enterovirus Infections - diagnosis; Enterovirus Infections - virology; Feces - virology; Fundamental and applied biological sciences. Psychology; gastroenteritis; HRV-A to C; Human rhinovirus; Human viral diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Picornaviridae Infections - diagnosis; Picornaviridae Infections - virology; Reverse Transcriptase Polymerase Chain Reaction - methods; Rhinovirus - classification; Rhinovirus - genetics; Rhinovirus - isolation & purification; Sensitivity and Specificity; Viral diseases; Viral Load; Virology; Virus Shedding; Picornaviridae; Gastroenteritis; Enterovirus; HRV-A to C; Human rhinovirus; Virus; Digestive diseases; Intestinal disease; Feces; diagnostic; Detection; Viral load; Gastric disease; Rhinovirus
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.23203

Human rhinoviruses (HRVs) can be divided into three species; HRV‐A to HRV‐C. Up to 148 different HRV (sero)types have been identified to date. Because of sequence similarity between 5′‐NCR of HRVs and enteroviruses (EVs), it is problematic to design EV‐specific RT‐PCR assays. The aims of this study were to assess the rate of false‐detection of different rhinoviruses by EV RT‐PCR, and to evaluate the diagnostic and clinical significance of such cross‐reactivity. In vitro RNA transcripts of HRV A‐C created from cDNA templates were quantified spectrophotometrically. Six hundred twenty‐one stool samples screened as part of routine diagnostic for EV, 17 EV‐positive stool samples referred for typing, 288 stool samples submitted for gastroenteritis investigations, and 1,500 CSF samples were included in the study. EV‐specific RT‐PCR detected RNA transcripts of HRV‐A1b, HRV‐B14, and HRV‐Crpat18 but with 10–1,000 reduced sensitivity compared to EV transcripts. Screening fecal samples by EV RT‐PCR identified 13 positive samples identified subsequently as rhinoviruses; a further 26 HRV‐positive samples were identified by nested HRV RT‐PCR. All individuals were hospitalized and presented mostly with diarrhea. A total of 26 HRV types were identified (HRV‐A: 46%; HRV‐B: 13%; HRV‐C: 41%). Results confirm that EV‐specific RT‐PCR can detect HRVs, and at a practical level, identify potential problems of interpretation if fecal samples are used for surrogate screening in cases of suspected viral meningitis. High detection frequencies (10%) and viral loads in stool samples provide evidence for enteric replication of HRV, and its association with enteric disease requires further etiological studies. J. Med. Virol. 84:536–542, 2012. © 2011 Wiley Periodicals, Inc.