Eradication of cryptosporidia and microsporidia following successful antiretroviral therapy.
OBJECTIVE
Incidence of opportunistic protozoal infections causing diarrheal illnesses in patients with HIV has decreased since the introduction of highly active antiretroviral therapy (HAART). The objective of this study was to determine whether the parasites, cryptosporidia, and microsporidia were effectively eradicated or only suppressed following treatment.


METHODS
Six HIV-positive patients with diarrheal symptoms caused by cryptosporidia or microsporidia were prospectively followed up with stool samples and duodenal biopsies. Samples were taken before HAART, between 1 to 3 months, and 6 months post-HAART.


METHODS
Duodenal samples were analyzed using routine histology and transmission electron microscopy. Stool samples were analyzed by both light microscopy and polymerase chain reaction (PCR) techniques.


RESULTS
Patients who responded successfully to HAART eradicated both cryptosporidial and microsporidial organisms. Symptoms improved within 1 month of therapy but complete eradication of the organisms was only observed after 6 months of treatment.


CONCLUSIONS
AIDs-related cryptosporidiosis and microsporidiosis can be cured following successful antiretroviral therapy.
Miao
Y M
YM
Department of HIV Medicine, St. Stephen's Centre, Chelsea and Westminster Hospital, London, UK.
Awad-El-Kariem
F M
FM
Franzen
C
C
Ellis
D S
DS
Müller
A
A
Counihan
H M
HM
Hayes
P J
PJ
Gazzard
B G
BG
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology; D000818:Animals; D023241:Antiretroviral Therapy, Highly Active; D003457:Cryptosporidiosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D016785:Cryptosporidium parvum; D003967:Diarrhea / Q000469:parasitology; D016819:Encephalitozoon; D021862:Enterocytozoon; D005243:Feces / Q000469:parasitology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D016881:Microsporidiosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D016133:Polymerase Chain Reaction