HIGH PREVALENCE OF ENTEROCYTOZOON-BIENEUSI INFECTIONS AMONG HIV-POSITIVE INDIVIDUALS WITH PERSISTENT DIARRHEA IN HARARE, ZIMBABWE

Infection with the microsporidian parasite Enterocytozoon bieneusi may be a major cause of prolonged diarrhoea in individuals also infected with human immunodeficiency virus (HIV). The parasite has been reporte d from Europe, Australia and the Americas, with a prevalence of 7-29%. Faecal specimens were obtained from 202 adults and 106 children in Ha rare, Zimbabwe, all of whom were in hospital and had diarrhoea. HIV se rology was available for 119 adults: 106 were HIV seropositive. There were clinical grounds for suspecting HIV infection in 23 of the remain ing patients. E. bieneusi was identified in specimens from 13/129 pati ents (10%) for whom HIV infection was indicated by serology and/or cli nical signs, 1/60 patients (2%) of uncertain HIV status, and 0/13 sero negative patients. 18/106 children were HIV seropositive and 12 were n ot; HIV serology was not available for the remainder, but 19 were stro ngly suspected of being infected with HIV on clinical criteria. E. bie neusi was not detected in samples from any child. As is common in Zimb abwe, the prevalence of other parasites in faecal specimens was low an d, amongst patients with proven or suspected HIV infection, E. bieneus i was the most prevalent parasite identified, particularly in patients with diarrhoea of over 4 weeks duration.