The epidemiology of intestinal microsporidiosis in patients with HIV/AIDS in Lima, Peru.
We studied microsporidiosis in human immunodeficiency virus-positive patients in 2 Lima hospitals. Of 2652 patients, 66% were male, 6% received antiretroviral therapy (ART), and the median CD4 lymphocyte count was 131 cells/microL. Sixty-seven patients (3%) had microsporidiosis; stool specimens from 56 were identified as having Enterocytozoon bieneusi of 10 different genotypes. The 2 most common genotypes, Peru-1 and Peru-2, were not associated with significant increases in chronic diarrhea; other genotypes were associated with a 4-fold increased risk. Risk factors for E. bieneusi infection segregated by genotype: contact with duck or chicken droppings and lack of running water, flush toilet, or garbage collection with genotype Peru-1 and watermelon consumption with other genotypes. Shortened survival was associated with low CD4 lymphocyte count (P<.0001), no ART (P<.0001), and cryptosporidiosis (P=.004) but not with microsporidiosis (P=.48). Our data suggest the possibility of zoonotic E. bieneusi transmission and an association with poor sanitary conditions.
Bern
Caryn
C
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. cbern@cdc.gov
Kawai
Vivian
V
Vargas
Daniel
D
Rabke-Verani
Jennifer
J
Williamson
John
J
Chavez-Valdez
Raul
R
Xiao
Lihua
L
Sulaiman
Irshad
I
Vivar
Aldo
A
Ticona
Eduardo
E
Navincopa
Marco
M
Cama
Vitaliano
V
Moura
Hercules
H
Secor
W Evan
WE
Visvesvara
Govinda
G
Gilman
Robert H
RH
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000401:mortality; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology*; D008297:Male; D016881:Microsporidiosis / Q000453:epidemiology*; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors