[Species identification of intestinal microsporidiosis in HIV-positive patients using the polymerase chain reaction].
BACKGROUND
Microsporidia are opportunistic parasites which, due to their morphologic characteristics, continue presenting diagnostic problems. Species-specific identification of microsporidia has become important because of varying levels of response to albendazole, which is the only effective treatment for some kinds of intestinal microsporidiosis. Although these parasites cause up to 50% of otherwise unexplained chronic diarrhea in HIV-positive patients, the number of reported cases is still very scarce in our country when compared to the existing HIV-positive population.


METHODS
Intestinal microsporidiosis in HIV-positive patients with diarrhea was investigated using the modified trichrome staining technique. Microsporidia species identification was done by indirect immunofluorescence (IIF) and polymerase chain reaction (PCR) with specific primers.


RESULTS
Six new cases of intestinal microsporidiosis caused by Enterocytozoon bieneusi were diagnosed in Madrid (Spain). All patients were in an advanced state of the HIV infection and they presented CD4+ values equal or inferior to 100 x 10(6)/I.


CONCLUSIONS
Due to the number of cases that are accumulating, microsporidia must be included among the enteropathogens responsible for chronic diarrhea in HIV-positive individuals in Spain. The PCR technique using specific primers is a suitable determinator of the microsporidia species implicated in this intestinal pathology.
del Aguila
C
C
Sección de Parasitología, Facultad de Ciencias Experimentales y Técnicas, Universidad San Pablo-CEU, Madrid.
Soriano
V
V
Navajas
R
R
Subirats
M
M
Fenoy
S
S
Valencia
E
E
Baquero
M
M
Pieniazek
N J
NJ
D017088:AIDS-Related Opportunistic Infections / Q000469:parasitology*; D000328:Adult; D000818:Animals; D018791:CD4 Lymphocyte Count; D016054:DNA, Protozoan / Q000032:analysis; D003967:Diarrhea / Q000469:parasitology; D005243:Feces / Q000469:parasitology; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000469:parasitology*; D008297:Male; D016816:Microsporida / Q000145:classification / Q000302:isolation & purification*; D016881:Microsporidiosis / Q000469:parasitology*; D016133:Polymerase Chain Reaction; D013045:Species Specificity; D013194:Staining and Labeling
D016054:DNA, Protozoan
Identificación específica de microsporidiosis intestinales en pacientes HIV-positivos mediante la reacción en cadena de la polimerasa.