[Campylobacter gastroenteritis in patients with human immunodeficiency virus infection]

Campylobacter bacteria are frequent, and usually slight causes of diarrhea in a normal host while in an immunosuppressed host the diarrhea may lead to severe pictures. The aim of this study was to analyze the clinical features of gastroenteritis by Campylobacter spp. in hospitalized seronegative patients and in those with HIV infection.

A retrospective study of the cases of gastroenteritis by Campylobacter spp. in adult patients admitted in the authors' hospital from January 1988 to July 1993 was carried out.

Of the 20 patients studied with gastroenteritis by Campylobacter spp., 13 (65%) had HIV infection. The mean age of the patients was 38 years (range: 18-68 years) with 70% of the cases being males. Seventy seven percent of the HIV positive patients showed diagnostic criteria for AIDS while 71% of the seronegative patients showed a base disease and/or received steroid therapy. The length of the diarrhea was greater in the patients with HIV infection on comparison with the seronegative patients (25 vs. 6 days). The diarrhea persisted for more than 2 weeks in more than half of the cases of seropositive patients. Fever continued a mean of 24 days in the HIV positive patients as compared with only 5 days in the HIV negative cases. Most of the former patients were treated with erythromycin with good response. Gastroenteritis recurred in one patient and another patient with HIV infection presented a pseudoappendicular picture. No case of bacteremia was detected in either the seropositive or seronegative patients. Campylobacter jejuni was isolated in most of the cases with a high percentage of resistence to quinolone drugs. The mean CD4 lymphocyte count in HIV positive patients was 131/mm3 (range: 1-774). Mean survival following diagnosis of gastroenteritis by Campylobacter spp. was 8.9 months (range: 1-17) in the patients with AIDS.

Gastroenteritis by Campylobacter spp. in hospitalized patients was related with immunosuppressive states. A clinical profile of prolonged febrile diarrhea was common in HIV positive patients and was associated with a low number of CD4 lymphocytes, advanced HIV infection and short survival.