title: Clinical Features of Human Immunodeficiency Virus-Infected Patients Presenting with Cholera in Port-au-Prince, Haiti.
abstract: Human immunodeficiency virus (HIV) infection has been postulated to alter the natural history of cholera, including increased susceptibility to infection, severity of illness, and chronic carriage of Vibrio cholerae Haiti has a generalized HIV epidemic with an adult HIV prevalence of 1.9% and recently suffered a cholera epidemic. We conducted a prospective study at the cholera treatment center (CTC) of GHESKIO in Haiti to characterize the coinfection. Adults admitted at the CTC for acute diarrhea were invited to participate in the study. Vital signs, frequency, and volume of stools and/or vomiting were monitored, and single-dose doxycycline was administered. After counseling, participants were screened for HIV by enzyme-linked immunosorbent assay and for cholera by culture. Of 729 adults admitted to the CTC, 99 (13.6%) had HIV infection, and 457 (63%) had culture-confirmed cholera. HIV prevalence was three times higher in patients without cholera (23%, 63/272) than in those with culture-confirmed cholera (7.9%, 36/457). HIV prevalence in patients with culture-confirmed cholera (7.9%) was four times higher than the adult prevalence in Port-au-Prince (1.9%). Of the 36 HIV-infected patients with cholera, 25 (69%) had moderate/severe dehydration versus 302/421 (72%) in the HIV negative. Of 30 HIV-infected patients with weekly stool cultures performed after discharge, 29 (97%) were negative at week 1. Of 50 HIV-negative patients with weekly stool cultures, 49 (98%) were negative at week 1. In countries with endemic HIV infection, clinicians should consider screening patients presenting with suspected cholera for HIV coinfection.
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Karine
authors.initials: K
authors.lastname: Sévère
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Stravinsky B
authors.initials: SB
authors.lastname: Anglade
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Claudin
authors.initials: C
authors.lastname: Bertil
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York.
authors.forename: Aynsley
authors.initials: A
authors.lastname: Duncan
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Deroncenay
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Mabou
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York.
authors.forename: Oksana
authors.initials: O
authors.lastname: Ocheretina
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Reif
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York. grs2013@med.cornell.edu.
authors.forename: Grace
authors.initials: G
authors.lastname: Seo
authors.affiliation: Groupe Haïtien Etude pour le Sarcome de Kaposi et les Infections Opportunistes (GHESKIO), Port-au-Prince, Haiti.|Center for Global Health, Weill Cornell Medical College, New York, New York.
authors.forename: Jean W
authors.initials: JW
authors.lastname: Pape
authors.affiliation: Center for Global Health, Weill Cornell Medical College, New York, New York.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002771:Cholera / Q000453:epidemiology* / Q000821:virology; D060085:Coinfection / Q000382:microbiology / Q000821:virology; D003681:Dehydration / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000453:epidemiology* / Q000382:microbiology*; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014734:Vibrio cholerae / Q000302:isolation & purification*; D014839:Vomiting / Q000382:microbiology / Q000821:virology; D055815:Young Adult