Isosporiasis in patients with HIV infection in the highly active antiretroviral therapy era in France.

Abstract

BACKGROUND:

Isosporiasis, a rare cause of diarrhoea among HIV-infected patients in the pre-highly active antiretroviral therapy (HAART) era, seems to be re-emerging.

METHODS:

A retrospective study was carried out for the period 1995-2003 in two hospitals in Paris to describe the prevalence, clinical characteristics and therapeutic outcome of isosporiasis in HIV-infected patients, and to compare the findings with those for cryptosporidiosis and microsporidiosis.

RESULTS:

The prevalence of isosporiasis increased from 0.4 per 1000 patients in the pre-HAART era (1995-1996) to 4.4 per 1000 patients in the HAART era (2001-2003), whereas the prevalence of cryptosporidiosis and microsporidiosis decreased. Compared with patients with either cryptosporidiosis (n=91) or microsporidiosis (n=58), patients with isosporiasis (n=28) more frequently originated from sub-Saharan Africa (72%), were more frequently female and heterosexual, and had a higher median CD4 count at diagnosis (142 cells/microL). All patients with isosporiasis presented with diarrhoea, which was severe enough to lead to hospital admission for 60% of them. Fever was uncommon (7%). All patients were treated for isosporiasis, 27 of them with cotrimoxazole. Relapse of isosporiasis occurred in six of 16 patients (38%) despite maintenance cotrimoxazole therapy and HAART.

CONCLUSION:

Isosporiasis in France occurs mostly in patients emigrating from sub-Saharan Africa and can induce severe diarrhoea. Relapse is common despite cotrimoxazole maintenance therapy.

• Authors: M Lagrange-Xélot, R Porcher, C Sarfati, N de Castro, O Carel, J-D Magnier, V Delcey, J-M Molina
• Journal: HIV medicine (HIV Med) Vol. 9 Issue 2 Pg. 126-30 (Feb 2008) ISSN: 1464-2662 [Print] England
• PMID: 18257775 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Anti-Infective Agents
• Trimethoprim, Sulfamethoxazole Drug Combination

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Infective Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Diarrhea (epidemiology, parasitology, virology)
• Female
• HIV Infections (complications, drug therapy, epidemiology)
• Humans
• Isosporiasis (drug therapy, epidemiology, virology)
• Male
• Middle Aged
• Paris (epidemiology)
• Prevalence
• Recurrence
• Retrospective Studies
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)