MAJOR DIFFERENCES IN THE SPECTRUM OF GASTROINTESTINAL INFECTIONS ASSOCIATED WITH AIDS IN INDIA VERSUS THE WEST - AN AUTOPSY STUDY

The spectrum of bowel infections in patients with AIDS in India is not well characterized. To examine this spectrum of infections, an autops y study of 49 subjects was carried out. Multiple sections were obtaine d from the gastrointestinal tract. A pathogenic organism was detected in 25 (71%) of 35 patients with diarrhea vs. 4 (29%) of 14 patients wi thout diarrhea (P < .01). The most frequent pathogen was cytomegalovir us (in 13; 27%), followed by parasites (9; 18%), fungi (8; 16%) and My cobacterium tuberculosis (7; 14%). This is the first autopsy study of patients with AIDS in the Indian subcontinent and shows important diff erences in the profile of their opportunistic infections compared with those of such patients in the West. These findings will help define t he optimal diagnostic and therapeutic approaches to patients with AIDS , which, in view of the considerable budgetary restrictions in develop ing countries, should be targeted toward the pathogens most frequently identified in such areas.