title: Etiology of chronic diarrhea in antiretroviral-naive patients with HIV infection admitted to Norodom Sihanouk Hospital, Phnom Penh, Cambodia.
abstract: BACKGROUND
  Although both human immunodeficiency virus (HIV) infection and diarrhea are considerable problems in Cambodia, there have not been any studies to determine the history, clinical presentation, and etiology of chronic diarrhea in patients with HIV infection in Cambodia. In this article, we present a case-control study involving 40 HIV-infected patients with chronic diarrhea and 40 HIV-infected patients without diarrhea.
  
  
  METHODS
  Clinical, demographic, and laboratory data were collected. Stool samples were examined for parasites, including Cryptosporidium species (by partial acid-fast stain), bacterial pathogens, and rotavirus. Samples from 10 case patients and 10 control subjects were also analyzed for Cryptosporidium species by polymerase chain reaction-restriction fragment-length polymorphism.
  
  
  RESULTS
  The median CD4(+) cell count was 11.5 cells/mm(3). A potential pathogen was found in 30 case patients (75%) and 29 control subjects (72.5%). Cryptosporidium was the most common pathogen, present in 16 case patients (40%) and 20 control subjects (53.3%). The presence of Cryptosporidium was confirmed by polymerase chain reaction-restriction fragment-length polymorphism, with a prevalence of 40% in each of the 2 groups of 10 subjects who were enrolled for Cryptosporidium evaluation.
  
  
  CONCLUSIONS
  Subjects in this cohort had severe immunosuppression. The prevalence of pathogens, including Cryptosporidium, was extremely high but did not differ significantly between the case patients with diarrhea and the control subjects without diarrhea. Further studies are needed to examine factors associated with Cryptosporidium carriage and the natural history of asymptomatic infection.
authors.affiliation: Department of Infectious Diseases, Preah Bat Norodom Sihanouk Hospital, Phnom Penh, Cambodia.
authors.forename: Senya
authors.initials: S
authors.lastname: Chhin
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Harwell
authors.forename: Joanna D
authors.initials: JD
authors.lastname: Bell
authors.forename: Gregory
authors.initials: G
authors.lastname: Rozycki
authors.forename: Tom
authors.initials: T
authors.lastname: Ellman
authors.forename: J Mark
authors.initials: JM
authors.lastname: Barnett
authors.forename: Honorine
authors.initials: H
authors.lastname: Ward
authors.forename: Steven E
authors.initials: SE
authors.lastname: Reinert
authors.forename: David
authors.initials: D
authors.lastname: Pugatch
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000503:physiopathology; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002160:Cambodia; D002908:Chronic Disease; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006761:Hospitals; D006801:Humans; D008297:Male
chemical_list: D044966:Anti-Retroviral Agents