ABSTRACT
Aim: Infection with Coxsackie B viruses has been linked to type 1 diabetes mellitus. Three of 18 serum samples [16.7%] taken from children at the onset of diabetes and two of 17 serum samples [11.8%] taken from adults in the course of type 1 DM [i.e. postonset] were positive for Coxsackie B virus. Subjects and We performed reverse transcriptase polymerase chain reaction [RT-PCR] to detect RNA of enteroviruses in serum samples. Subsequent virus isolation and neutralization test were done using polyvalent and then monovalent anti Coxsackie B [CB] sera to detect CB serotype. Three patients had Coxsakie virus B4 [2 children and one adult] and 2 patients had Coxsackie virus B3 [one child and one adult]. By contrast none of the 20 age and sex matched healthy control [10 children and 10 adults] had Coxsackie viruses in their serum samples. All five patients positive for Coxsackie virus gave positive history of metabolic decompensation i.e. ketosis either at the onset or in the course of the disease [P = 0.002, Fisher's exact test]. By contrast none of the Coxsackie negative diabetic children [0%] and 7 of 15 Coxsackie negative diabetic adults [46.7%] gave past history of ketosis [P = 0.001 and P = 0.47, respectively]. Conclusions: The present study demonstrates that Coxsackie B virus RNA can be detected in serum from children at the onset and adults in the course of type 1 DM and that it may play a role in triggering metabolic decompensation especially in children. Coxsackie B4 and B3 strains may specially have diabetogenic properties. The present study provides further evidence for a role of enteroviruses in children and adult type 1 diabetes