Amebic infections in asymptomatic homosexual men, lack of evidence of invasive disease.

Sorvillo, Frank; Strassburg, Marc A.; Seidel, Judith A.; Visvesvara, Govinda S.; Mori, Kunio; Todd, A.S.; Portigal, Lawrence; Finn, Mary Beth; Agee, Bettya .

doi:10.2105/ajph.76.9.1137

Cited by 22 publications

(16 citation statements)

References 34 publications

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“…Serological examination was also useful for the diagnosis. It has been reported that asymptomatic amebic infections rarely develop serologic response (7,13). The antibody positive result for E. histolytica indicated an invasive disease in the present report (14,15).…”

Section: Discussionsupporting

confidence: 60%

Amebiasis in Japanese Homosexual Men with Human Immunodeficiency Virus Infection.

et al. 2001

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Wereport cases of amebiasis in 6 human immunodeficiency virus (HlV)-positive male patients. Five were confirmed homosexualswhile one was suspected. Three patients had liver abscess and 5 had colitis with duration of 10 days to months. The patients with liver abscess showeda lower incidence of abdominal pain but a higher incidence of concomitant diarrhea. Drainage therapy was effective for rapid afebrile results. Twoinvasive colitis cases died from perforation. This may have been due to delayed diagnosis. Invasive amebiasis is not commoneven in HIV-infected individuals. AmongJapanese homosexual men, however, it may cause symptomatic diseases. (Internal Medicine 40: 671-675, 2001)

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Section: Discussionsupporting

confidence: 60%

Amebiasis in Japanese Homosexual Men with Human Immunodeficiency Virus Infection.

et al. 2001

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“…1,3,4,6,7 Because E. dispar and E. histolytica share the same transmission route, it is not unexpected that risk of E. histolytica infection will also increase in persons with risky sexual contact with individuals who reside in or travel to areas that are endemic for E. histolytica infection. 16 Most of the infections with E. histolytica are asymptomatic and carriage of E. histolytica may be prolonged, 23 and therefore, spread of E. histolytica is likely to occur in the gay community in endemic areas for E. histolytic a infection when unprotected oral-anogenital sexual practices are adopted.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] In several developed countries in Asia, studies have shown that E. histolytica infection has become an emerging parasitic infection in MSM, especially those who are human immunodeficiency virus (HIV) infected. [8][9][10][11][12][13][14] In Japan, 80% of the annually reported 500-600 cases occurred in MSM 10 ; and the seroprevalence of MSM was estimated 13.4-20.4% compared with 1.0% in heterosexuals and 0.8% in prostitutes.…”

Section: Introductionmentioning

confidence: 99%

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Amebiasis among Persons Who Sought Voluntary Counseling and Testing for Human Immunodeficiency Virus Infection: A Case-Control Study

Hung¹,

Wu²,

Chang³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. This case-control study aimed to characterize the factors associated with amebiasis, defined as presence of anti-Entamoeba histolytica antibody titers of ³ _ 128 by indirect hemagglutination assay, among persons seeking voluntary counseling and testing (VCT) for human immunodeficiency virus (HIV) infection. Between April 2006 and September 2009, 57 of 4,802 persons (1.2%) seeking VCT services were seropositive for E. histolytica infection. Compared with 228 seronegative controls, case subjects were older (odds ratio [OR] for per 1-year increase, 1.098; 95% confidence interval [CI], 1.036, 1.165), less likely to hold bachelor degree or higher (OR, 0.359; 95% CI, 0.152, 0.846), and were more likely to be men who have sex with men (MSM) (OR, 8.382; 95% CI, 2.050, 34.266) and have oral-anal sex (OR, 4.016; 95% CI, 1.711, 9.427) in multiple logistic regression analysis. The MSM, fecal-oral contamination, lower educational achievement, and older age were associated with increased risk for amebiasis among persons seeking VCT for HIV infection.* Address correspondence to Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital, 7 ChungShan South Road, Taipei, Taiwan 100. E-mail: hcc0401@ntu.edu.tw 66 HUNG AND OTHERS previously described.9 After a pilot study to assess the costeffectiveness of detection of E. histoytica in stool specimens in those persons seeking VCT services and HIV care, 21 we have found that E. histolytica in persons who were seronegative for E. histolytica was rarely detectable; among 345 persons who underwent IHA serological assays and specific stool amebic antigen assays, 24 of 36 (66.7%) who were seropositive for E. histolytica had intestinal amebiasis by antigen assays, compared with 2 of 309 (0.2%) who were seronegative (odds ratio [OR], 307; 95% confidence interval [CI], 64.9, 1,451). 21Therefore, those who were seronegative for E. histolytica were not requested to submit stool specimens while counseling for amebiasis was provided.Amebiasis is a reportable disease in Taiwan. Those persons diagnosed with amebiasis will be reported to Centers for Disease Control, Taiwan and treatment with metronidazole 500 mg thrice daily for 7-10 days followed by luminal agents (iodoquinol or paromomycin) to eradicate intestinal carriage. Three consecutive stool specimens were collected 1 week after completion of luminal agents and were subjected to specific amoebic antigen assays. To prevent further transmission of E. histolytica , we encourage the persons with amebiasis to contact their identifiable sexual partners and examinations and treatment of amebiasis will be provided free of charge as well.Case and control. A case of amebiasis was defined as presence of an IHA titer of ³ _ 128. Four control subjects who were seronegative for E. histolytica infection were selected for each case and matched only for date when the case subject sought VCT: two controls before and two controls after the date. Because higher IHA titers may persist for a certain period of time, only t...

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“…'6-'9 The introduction of zymodeme classification (the grouping of isolates according to their isoenzyme pattern on electrophoresis) has provided a rational explanation for the lack of clinical disease in many people infected with E histolytica. Twenty two different zymodemes ofE histolytica have been shown, 12 of which have never been associated with invasive amoebiasis and have therefore been designated non-pathogenic.2029 Classification of isolates of E histolytica from homosexual men in the United Kingdom and North America has to date shown them all to belong to non-pathogenic zymodemes.51" 4'530 Information on the natural course of infections with non-pathogenic E histolytica is scant. In a study that followed up 15 subjects passing cysts of E histolytica, some of which were known to be non-pathogenic, all subjects lost the parasite within 18 months.3' No such study has been carried out on homosexual men, a group in which the high prevalence of infection with human immunodeficiency virus (HIV) and consequent immune suppression are added complications.…”

Section: Introductionmentioning

confidence: 99%

Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV antibody.

Allason-Jones

Mindel

Sargeaunt

et al. 1988

BMJ

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individual districts, each currently with about 60 deaths from breast cancer a year, would scarcely be measurable in the short to medium term, even if an efficient deployment were immediately attained. It would therefore seem sensible to conduct sequential and comparative evaluations for groups of 10 or 20 health districts rather than for one or two.The working group calculated a cost of £3000 to £3400 for one life year saved, at AbstractAmong homosexual men the prevalence of infection with Entamoeba histolytica is high. To determine the clinical importance of this infection 55 homosexual men carrying the parasite were investigated in detail. No clinical, serological, or histological evidence of invasive amoebiasis was found in any of them. The patients were not treated and were foliowed up for 12 to 29 months (mean 21-6 months), during which period none developed symptoms that could be attributed to E histolytica. Spontaneous loss of the parasite occurred in 17 patients, some of whom later became reinfected. Sixteen patients had antibody to human immunodeficiency virus, and infection with E histolytica showed the same benign course in them as in the patients who did not have antibody. Throughout the study classification of the isolates of E histolytica consistently showed that they belonged only to non-pathogenic zymodemes. The findings provide further evidence that E histolytica in homosexual men is a commensal organism.

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Amebic infections in asymptomatic homosexual men, lack of evidence of invasive disease.

Cited by 22 publications

References 34 publications

Amebiasis in Japanese Homosexual Men with Human Immunodeficiency Virus Infection.

Amebiasis in Japanese Homosexual Men with Human Immunodeficiency Virus Infection.

Amebiasis among Persons Who Sought Voluntary Counseling and Testing for Human Immunodeficiency Virus Infection: A Case-Control Study

Outcome of untreated infection with Entamoeba histolytica in homosexual men with and without HIV antibody.

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