PREVALENCE OF INTESTINAL PROTOZOANS IN FRENCH PATIENTS INFECTED WITH HIV

To assess the prevalence of intestinal protozoans in French HIV-infect ed patients, stool samples, duodenojejunal biopsies, and/or colorectal biopsies from 81 patients were studied for parasites, viruses, and ba cteria. Pathogens were found in 70.6% of AIDS patients with diarrhea o r malabsorption. The respective prevalence of protozoa in AIDS patient s 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 mala bsorption but no diarrhea. Other pathogens included cytomegalovirus in 27.4% and Mycobacterium avium in 5.8%. Patients with identified patho gens were more immunosuppressed and more severely malnourished than th ose with unexplained diarrhea. Multiple pathogens were found in 13 of 81 patients (16%). Twenty-six of 66 identified pathogens (40%) were di agnosed only on biopsy specimens. Chronic diarrhea in HIV patients cou ld be explained in the vast majority by appropriate gastrointestinal i nvestigations. Cryptosporidia played a major role, while microsporidia appeared to be less common.