TY - JOUR
T1 - The role of Microsporidia in the pathogenesis of HIV-related chronic diarrhea
AU - Rabeneck, Linda
AU - Gyorkey, Ferenc
AU - Genta, Robert M.
AU - Gyorkey, Phyllis
AU - Foote, Lorraine W.
AU - Risser, Jan M H
PY - 1993/11/1
Y1 - 1993/11/1
N2 - ■ Objective: To determine whether infection with Microsporidia leads to diarrhea in patients with human immunodeficiency virus (HIV) infection. ■ Design: Case-control study. ■ Setting: Primary care outpatient HIV clinic at a Veterans Affairs medical center. ■ Patients: One hundred six HIV-infected men, 55 with and 51 without chronic diarrhea. ■ Measurements: Each patient underwent upper endoscopy and flexible sigmoidoscopy to obtain duodenal, rectal, and sigmoid colonic biopsy specimens. At the time of endoscopy, a fresh stool was obtained for culture, ova and parasite assessment, and Cryptosporidium examination. Biopsy tissue was examined using electron microscopy to detect Microsporidia. ■ Results: The microsporidian parasite Enterocytozoon bieneusi was detected in the duodenal biopsy specimens of 31 of 106 men (29%); 24 of 106 men (23%) had other enteric pathogens. No significant difference was observed in the occurrence of microsporidiosis in patients with (18 of 55 [33%]) and without (13 of 51 [25%]) chronic diarrhea (odds ratio, 1.42; 95% Cl, 0.61 to 3.31). A similar nonsignificant difference was observed after controlling for CD4 count and other enteric pathogens (odds ratio, 1.66; 95% Cl, 0.68 to 4.06). Among patients with microsporidiosis, no difference was observed in the intensity of infection (defined by the presence of few, moderate, or abundant organisms) among cases and controls (P > 0.2). ■ Conclusions: This is the first report to document the presence of E. bieneusi m HIV-positive patients without gastrointestinal symptoms. No significant difference was observed in the occurrence of E. bieneusi infection in HIV-infected patients with or without chronic diarrhea. Thus, the association between microsporidiosis and diarrhea, if one exists, may not be as strong as is currently believed.
AB - ■ Objective: To determine whether infection with Microsporidia leads to diarrhea in patients with human immunodeficiency virus (HIV) infection. ■ Design: Case-control study. ■ Setting: Primary care outpatient HIV clinic at a Veterans Affairs medical center. ■ Patients: One hundred six HIV-infected men, 55 with and 51 without chronic diarrhea. ■ Measurements: Each patient underwent upper endoscopy and flexible sigmoidoscopy to obtain duodenal, rectal, and sigmoid colonic biopsy specimens. At the time of endoscopy, a fresh stool was obtained for culture, ova and parasite assessment, and Cryptosporidium examination. Biopsy tissue was examined using electron microscopy to detect Microsporidia. ■ Results: The microsporidian parasite Enterocytozoon bieneusi was detected in the duodenal biopsy specimens of 31 of 106 men (29%); 24 of 106 men (23%) had other enteric pathogens. No significant difference was observed in the occurrence of microsporidiosis in patients with (18 of 55 [33%]) and without (13 of 51 [25%]) chronic diarrhea (odds ratio, 1.42; 95% Cl, 0.61 to 3.31). A similar nonsignificant difference was observed after controlling for CD4 count and other enteric pathogens (odds ratio, 1.66; 95% Cl, 0.68 to 4.06). Among patients with microsporidiosis, no difference was observed in the intensity of infection (defined by the presence of few, moderate, or abundant organisms) among cases and controls (P > 0.2). ■ Conclusions: This is the first report to document the presence of E. bieneusi m HIV-positive patients without gastrointestinal symptoms. No significant difference was observed in the occurrence of E. bieneusi infection in HIV-infected patients with or without chronic diarrhea. Thus, the association between microsporidiosis and diarrhea, if one exists, may not be as strong as is currently believed.
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U2 - 10.7326/0003-4819-119-9-199311010-00005
DO - 10.7326/0003-4819-119-9-199311010-00005
M3 - Article
C2 - 8215001
AN - SCOPUS:0027369835
SN - 0003-4819
VL - 119
SP - 895
EP - 899
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 9
ER -