While most Entamoeba histolytica appearing in male homosexuals infected with human immunodeficiency virus (HIV) is considered non-invasive in Western countries, and treatment of
amebiasis in these persons has received very little attention, in Japan some male homosexual
amebiasis patients infected with HIV complain of symptoms attributable to E. histolytica
infection. We investigated whether symptomatic E histolytica
amebic colitis in HIV-infected persons requires higher doses or longer duration of antiamebic
drug therapy than in non HIV-infected patients. Four symptomatic
amebic colitis patients infected with HIV-1, three of them severely immunocompromised, with CD4 cell counts <200/mm(3), were treated with oral
metronidazole: 1500 mg a day for 10 days in 2 patients, 1000 mg a day for 10 days in 1 patient, and 1000 mg a day for 6 days and then 750 mg for 4 days in 1 patient, and good therapeutic results with no side effects were obtained. This indicates that symptomatic
amebic colitis in HIV-infected persons can be successfully treated with
metronidazole at the same dose and
duration of treatment used in non-HIV-infected persons.