PREVALENCE AND CLINICAL-SIGNIFICANCE OF INTESTINAL MICROSPORIDIOSIS IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS WITH AND WITHOUT DIARRHEA IN GERMANY - A PROSPECTIVE COPRODIAGNOSTIC STUDY

The prevalence of intestinal microsporidiosis among human immunodefici ency virus (HIV)-infected persons with chronic diarrhea varies from 7% to 50%; thus, microsporidia are a significant source of morbidity and , occasionally, mortality among these patients, Anecdotal reports sugg est that intestinal microsporidiosis is also an important infection in patients with AIDS in Germany, To determine the prevalence of microsp oridiosis among HIV-infected patients in Germany, we performed a prosp ective coprodiagnostic study of 97 consecutive HIV-infected patients, Microsporidia were the most common enteropathogen identified in 18 (36 .0%) of 50 patients with diarrhea and 2 (4.3%) of 47 patients without diarrhea (P <.001; chi(2) test), Microsporidia were present in 60% of patients with chronic diarrhea and 5.9% of patients with acute diarrhe a. The etiologic agent was Enterocytozoon bieneusi in 18 patients and Encephalitozoon intestinalis in two patients, The prevalence of intest inal microsporidiosis in this cohort of German patients with AIDS and diarrhea is one of the highest to be reported anywhere in the world, M icrosporidiosis seems to represent one of the most important causes of diarrhea in HIV-infected patients in Germany and thus must be conside red in the differential diagnosis for all AIDS patients presenting wit h diarrhea.