Related Experiment Videos
Prevalence of intestinal protozoans in French patients infected with HIV
L Cotte1, M Rabodonirina, M A Piens
1Hepatogastroenterology and AIDS Unit, Hôpital de l'Hôtel-Dieu, Lyon, France.
Abstract:
To assess the prevalence of intestinal protozoans in French HIV-infected patients, stool samples, duodenojejunal biopsies, and/or colorectal biopsies from 81 patients were studied for parasites, viruses, and bacteria. Pathogens were found in 70.6% of AIDS patients with diarrhea or malabsorption. The respective prevalence of protozoa in AIDS patients with diarrhea was Cryptosporidium sp.: 37.3%, Blastocystis hominis: 13.7%, Giardia intestinalis: 5.8%, Isospora belli: 2%, Enterocytozoon bieneusi: 2%. Microsporidia were noted in one patient with severe malabsorption but no diarrhea. Other pathogens included cytomegalovirus in 27.4% and Mycobacterium avium in 5.8%. Patients with identified pathogens were more immunosuppressed and more severely malnourished than those with unexplained diarrhea. Multiple pathogens were found in 13 of 81 patients (16%). Twenty-six of 66 identified pathogens (40%) were diagnosed only on biopsy specimens. Chronic diarrhea in HIV patients could be explained in the vast majority by appropriate gastrointestinal investigations. Cryptosporidia played a major role, while microsporidia appeared to be less common.
Insights
In HIV-infected patients with diarrhea, Cryptosporidium was the most common intestinal protozoan. Gastrointestinal investigations effectively identified pathogens, explaining most cases of chronic diarrhea.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Chronic diarrhea and malabsorption are significant complications in Human Immunodeficiency Virus (HIV)-infected patients.
- Identifying causative pathogens is crucial for effective management and improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of intestinal protozoan infections in a cohort of HIV-infected patients in France.
- To investigate the role of various pathogens, including protozoa, viruses, and bacteria, in gastrointestinal symptoms.
Main Methods:
- Analysis of stool samples and/or intestinal biopsies (duodenojejunal, colorectal) from 81 HIV-infected patients.
- Parasitological, viral, and bacterial investigations were performed on collected specimens.
Main Results:
- Pathogens were identified in 70.6% of AIDS patients presenting with diarrhea or malabsorption.
- Cryptosporidium sp. (37.3%) was the most prevalent protozoan, followed by Blastocystis hominis (13.7%) and Giardia intestinalis (5.8%).
- Cytomegalovirus (27.4%) and Mycobacterium avium (5.8%) were also identified; 40% of pathogens were diagnosed solely via biopsy.
Conclusions:
- Gastrointestinal investigations can explain the majority of chronic diarrhea cases in HIV patients.
- Cryptosporidium is a major contributor to diarrhea in this population, while microsporidia appear less frequent.
- Patients with identified pathogens exhibited greater immunosuppression and malnutrition.