Intestinal protozoa in HIV-infected patients: Effect of rifaximin in Cryptosporidium parvum and Blastocystis hominis infections

In HIV-1 infected patients severe enteritis and chronic diarrhea are often documented as a consequence of multiple opportunistic infections, We analyz ed 48 HIV-1 positive patients for the presence of intestinal pathogenic pro tozoa, Patients with CD4 greater than or equal to 200/mm(3) showed a higher prevalence of a single pathogenic protozoa than patients with CD4 less tha n or equal to 200/mm(3), who showed the presence of multiple protozoal infe ctions. Patients who proved positive for only a single protozoa, Cryptospor idium or Blastocystis, were also positive, by stool culture, for the presen ce of Proteus mirabilis (3 samples), Citrobacter freundii (3 samples), Esch erichia coli (one sample) or Enterobacter cloacae (one sample). Treatment w ith rifaximin (600 mg, 3 times a day, for 14 days) was efficacious in resol ving the clinical symptoms and clearing protozoan infections in HIV-1 infec ted patients with CD4 greater than or equal to 200/mm(3), who presented ent eric and systemic symptoms due to Criptosporidium or Blastocystis associate d with enteropathogenic bacteria.