Prevalence of intestinal protozoans in French patients infected with HIV.
To assess the prevalence of intestinal protozoans in French HIV-infected patients, stool samples, duodenojejunal biopsies, and/or colorectal biopsies from 81 patients were studied for parasites, viruses, and bacteria. Pathogens were found in 70.6% of AIDS patients with diarrhea or malabsorption. The respective prevalence of protozoa in AIDS patients with diarrhea was Cryptosporidium sp.: 37.3%, Blastocystis hominis: 13.7%, Giardia intestinalis: 5.8%, Isospora belli: 2%, Enterocytozoon bieneusi: 2%. Microsporidia were noted in one patient with severe malabsorption but no diarrhea. Other pathogens included cytomegalovirus in 27.4% and Mycobacterium avium in 5.8%. Patients with identified pathogens were more immunosuppressed and more severely malnourished than those with unexplained diarrhea. Multiple pathogens were found in 13 of 81 patients (16%). Twenty-six of 66 identified pathogens (40%) were diagnosed only on biopsy specimens. Chronic diarrhea in HIV patients could be explained in the vast majority by appropriate gastrointestinal investigations. Cryptosporidia played a major role, while microsporidia appeared to be less common.
Cotte
L
L
Hepatogastroenterology and AIDS Unit, Hôpital de l'Hôtel-Dieu, Lyon, France.
Rabodonirina
M
M
Piens
M A
MA
Perreard
M
M
Mojon
M
M
Trepo
C
C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000818:Animals; D015331:Cohort Studies; D003106:Colon / Q000469:parasitology / Q000473:pathology; D003457:Cryptosporidiosis / Q000150:complications / Q000453:epidemiology; D003458:Cryptosporidium / Q000302:isolation & purification; D003967:Diarrhea / Q000150:complications / Q000469:parasitology; D004386:Duodenum / Q000469:parasitology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D056890:Eukaryota / Q000302:isolation & purification; D005243:Feces / Q000469:parasitology; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications / Q000453:epidemiology*; D007583:Jejunum / Q000469:parasitology / Q000473:pathology; D008286:Malabsorption Syndromes / Q000150:complications / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011528:Protozoan Infections / Q000150:complications / Q000453:epidemiology*; D012007:Rectum / Q000469:parasitology / Q000473:pathology