Cryptosporidial and Microsporidial Infections in Human Immunodeficiency Virus-Infected Patients in Northeastern Brazil

Abstract

To determine the frequency of the parasitic pathogens in human immunodeficiency virus (HIV)-infected patients in a developing world setting, 295 stool specimens were examined from 166 HIV-positive patients (49% with AIDS) at São José Hospital, Fortaleza, Brazil, from September 1990 to March 1992. Significantly more patients with diarrhea (85%) than without (66%) had AIDS or AIDS-related complex (ARC) (P < .005). Of the potential parasitic causes of diarrhea, only Cryptosporidium parvum and microsporidia were significantly associated with diarrheal disease. Infections with C. parvum, but not microsporidia, were associated with the rainy season (P < .005). Thus, C. parvum and microsporidia are the most common intestinal parasites associated with diarrhea in an HIV-infected population in Brazil and are associated with advanced HIV disease. The association of C. parvum infections with the rainy season suggests that contaminated water may be important in its transmission; however, the source of human microsporidia requires further investigation.

Examination of the prevalence and seasonal variation of intestinal microsporidiosis in the stools of persons with chronic diarrhea and human immunodeficiency virus infection.

“…However, seasonal prevalence of both C. parvum and microsporidiosis was examined in Brazil, a developing country with a rainy season. 4 In that study, an excess of C. parvum infection was noted during the rainy season, but no corresponding seasonal variation was noted in the prevalence of human microsporidiosis. 4 These findings by Wuhib and others, 4 who evaluated 295 stool specimens collected from 166 human immunodeficiency virus (HIV)-infected persons over an 18-month period, suggested that contaminated water was not likely to be a major source of microsporidial infection.…”

“…4 In that study, an excess of C. parvum infection was noted during the rainy season, but no corresponding seasonal variation was noted in the prevalence of human microsporidiosis. 4 These findings by Wuhib and others, 4 who evaluated 295 stool specimens collected from 166 human immunodeficiency virus (HIV)-infected persons over an 18-month period, suggested that contaminated water was not likely to be a major source of microsporidial infection. The goal of the present study was to examine the seasonal variation and prevalence of microsporidia in the stools of HIV-infected persons with chronic diarrhea in southern California over a four-year period.…”

Climate variability and change in the United States: potential impacts on water- and foodborne diseases caused by microbiologic agents.

“…The Nevada outbreak was associated with water from Lake Mead that was both filtered and chlorinated. Researchers in Brazil reported that Cryptosporidium was the most common cause of diarrhea in AIDS patients, and disease incidence showed a distinct seasonality, suggesting an association with rainfall (26).…”

Intestinal parasitic infections in HIV/AIDS patients: epidemiological, nutritional and immunological aspects

“…Since the emergence of AIDS, clinical alterations related to the gastrointestinal tract have been highly prevalent, of which diarrheic conditions associated to parasitic infections are noteworthy (2). Many studies have shown that some intestinal parasites were frequently associated with severe diarrhea in HIV patients, both in developed and developing countries (2)(3)(4)(5)(6)(7)(8). Socioeconomic and cultural factors have carefully been studied for the impact that they may have on the onset of enteroparasitosis in general and in HIV-infected patients (9).…”