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Protists as opportunistic pathogens: public health impact in the 1990s and beyond
J E Kaplan1, J L Jones, C A Dykewicz
1Division of AIDS, STD and TB Laboratory Research, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. jxk2@cdc.gov
Abstract:
Protist organisms (protozoa and fungi) have become increasingly prominent as opportunistic pathogens among persons infected with human immunodeficiency virus (HIV) and among organ transplant recipients--two immunocompromised populations that have increased dramatically in the past two decades. Pneumocystis carinii pneumonia continues to be the most common serious opportunistic infection (OI) among HIV-infected persons in the United States, occurring frequently among persons not previously receiving medical care. Toxoplasmosis, cryptococcosis, cryptosporidiosis, and isosporiasis occur frequently in HIV-infected persons in the developing world. Candidiasis and aspergillosis are common OIs in organ transplant recipients. As these populations of immunosuppressed patients continue to expand worldwide new OIs caused by protist pathogens are likely to emerge.
Insights
Opportunistic protist infections are a growing concern in immunocompromised individuals, particularly those with human immunodeficiency virus (HIV) and organ transplant recipients. Early detection and management are crucial for these vulnerable populations.
Area of Science:
- Immunology
- Infectious Diseases
- Microbiology
Background:
- Protist pathogens (protozoa and fungi) are increasingly recognized as opportunistic infections.
- Immunocompromised populations, including those with human immunodeficiency virus (HIV) and organ transplant recipients, are at higher risk.
- The prevalence of these conditions has risen significantly in recent decades.
Purpose of the Study:
- To highlight the growing threat of protist opportunistic infections in specific patient groups.
- To identify common protist-related opportunistic infections in HIV-infected individuals and organ transplant recipients.
- To underscore the potential emergence of new protist opportunistic infections.
Main Methods:
- Review of current literature and clinical observations.
- Analysis of epidemiological trends in opportunistic infections.
- Identification of key protist pathogens and associated clinical syndromes.
Main Results:
- Pneumocystis carinii pneumonia is the most frequent serious opportunistic infection in HIV-infected individuals in the US.
- Toxoplasmosis, cryptococcosis, cryptosporidiosis, and isosporiasis are prevalent in HIV-infected persons globally.
- Candidiasis and aspergillosis are common opportunistic infections in organ transplant recipients.
Conclusions:
- Protist opportunistic infections pose a significant challenge in immunocompromised patients.
- Continued expansion of immunosuppressed populations worldwide may lead to the emergence of novel protist opportunistic infections.
- Vigilance and further research are necessary to combat these infections.