Intestinal protozoa in HIV-infected patients in Apulia, South Italy.
Protozoa are important enteric pathogens in patients with human immunodeficiency virus (HIV) infection. In this study the prevalence of intestinal protozoa in 154 HIV-infected patients, with or without diarrhoea, in our region (Apulia, South Italy) was evaluated between December 1993 and February 1998. In the majority of patients CD4+ T cell count was below 200/microl. The overall prevalence of intestinal protozoa was 43/154 (27.92%). Twenty-eight (43.08%) out of 65 patients with diarrhoea and 15 (16-85%) out of 89 non-diarrhoeic patients were parasitized. In particular, in the group of 65 patients with diarrhoea the following protozoa were identified: Cryptosporidium parvum in 14 (21.54%), Blastocystis hominis in 7 (10.77%), microsporidia in 6 (9.23%), Giardia lamblia in 4 (6.15%) and Isospora belli in 1 (1.54%). Three patients were Cryptosporidium parvum-microsporidia co-infected. In patients without intestinal symptoms, prevalence was 3/89 (3.37%) for Cryptosporidium parvum, 9/89 (10.11%) for Blastocystis hominis, 1/89 (1.12%) for microsporidia and 2/89 (2.25%) for Giardia lamblia. A significant (P<0.001) correlation was observed between protozoan infection and the presence of diarrhoea. In particular, Cryptosporidium parvum and microsporidia infections were significantly (P<0.001) and P = 0.046, respectively) associated with diarrhoeal illness. Moreover, the majority of cases of cryptosporidiosis were first diagnosed in the periods of heaviest rainfall. Therefore, drinking water contamination may be a possible source of human infection in our area.
Brandonisio
O
O
Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, University of Bari, Policlinico, Italy.
Maggi
P
P
Panaro
M A
MA
Lisi
S
S
Andriola
A
A
Acquafredda
A
A
Angarano
G
G
D000328:Adult; D000818:Animals; D003967:Diarrhea / Q000209:etiology / Q000469:parasitology; D004064:Digestive System / Q000469:parasitology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000469:parasitology; D006801:Humans; D015994:Incidence; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011528:Protozoan Infections / Q000453:epidemiology*; D014881:Water Supply