Modification of the clinical course of intestinal microsporidiosis in acquired immunodeficiency syndrome patients by immune status and anti-human immunodeficiency virus therapy.
The clinical course of 37 Enterocytozoon bieneusi-infected acquired immunodeficiency syndrome patients with diarrhea was studied. Parasite clearance was seen in 15 patients (40.5%). Clearance of E. bieneusi resulted in a 25-100% reduction in episodes of diarrhea, suggesting that microsporidia are true pathogens. Univariate and multivariate proportional hazards analyses revealed that peripheral blood CD4 cell counts > or = 100/mm3, the use of two or more antiretroviral medications, and use of a protease inhibitor were statistically associated with decreased time to clearance of E. bieneusi. Specific anti-microsporidial therapy (albendazole) was not associated with parasite eradication. Factors related to immunocompetence and human immunodeficiency virus suppression appeared to be important in the clearance of E. bieneusi.
Conteas
C N
CN
Division of Gastroenterology, Southern California Permanente Medical Group, Los Angeles 90027, USA.
Berlin
O G
OG
Speck
C E
CE
Pandhumas
S S
SS
Lariviere
M J
MJ
Fu
C
C
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000469:parasitology*; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D000704:Analysis of Variance; D000818:Animals; D019380:Anti-HIV Agents / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007411:Intestinal Diseases, Parasitic / Q000209:etiology / Q000469:parasitology*; D008297:Male; D016816:Microsporida / Q000302:isolation & purification; D016881:Microsporidiosis / Q000209:etiology / Q000469:parasitology*; D008875:Middle Aged; D011480:Protease Inhibitors / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood*
D019380:Anti-HIV Agents; D011480:Protease Inhibitors; D012367:RNA, Viral