title: The epidemiology of intestinal microsporidiosis in patients with HIV/AIDS in Lima, Peru.
abstract: 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.
authors.affiliation: Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. cbern@cdc.gov
authors.forename: Caryn
authors.initials: C
authors.lastname: Bern
authors.forename: Vivian
authors.initials: V
authors.lastname: Kawai
authors.forename: Daniel
authors.initials: D
authors.lastname: Vargas
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rabke-Verani
authors.forename: John
authors.initials: J
authors.lastname: Williamson
authors.forename: Raul
authors.initials: R
authors.lastname: Chavez-Valdez
authors.forename: Lihua
authors.initials: L
authors.lastname: Xiao
authors.forename: Irshad
authors.initials: I
authors.lastname: Sulaiman
authors.forename: Aldo
authors.initials: A
authors.lastname: Vivar
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ticona
authors.forename: Marco
authors.initials: M
authors.lastname: Navincopa
authors.forename: Vitaliano
authors.initials: V
authors.lastname: Cama
authors.forename: Hercules
authors.initials: H
authors.lastname: Moura
authors.forename: W Evan
authors.initials: WE
authors.lastname: Secor
authors.forename: Govinda
authors.initials: G
authors.lastname: Visvesvara
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
mesh_terms: 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