Isosporiasis in Venezuelan Adults Infected With Human Immunodeficiency Virus: Clinical Characterization

Abstract

A cross-sectional study was undertaken to determine the prevalence of isosporiasis and its clinical and laboratory pattern in Venezuelan patients infected with human immunodeficiency virus (HIV) (n ‫ס‬ 397). At enrollment, they underwent a thorough clinical history and physical examination, and provided stool specimens for the identification of Isospora belli and other parasites. Isospora belli was identified in 56 subjects (14%) and diarrhea, either acute or chronic, was present in 98% of these cases (P < 0.001). Eosinophilia was strongly associated with isosporiasis (P ‫ס‬ 0.01). It was also found that the presence of eosinophilia was more common in I. belli-infected patients without weight loss (P < 0.001). Twenty-six (81.25%) subjects with I. belli infection had CD4 + cell counts < 200 cells/mm 3 (P ‫ס‬ 0.03). In addition, the data and its description shows the association to be < 100 cells/mm 3 . This infection seems to be seasonal because the recovery of oocysts occurred mainly in months with significant rainfall. In fact, isosporiasis should be suspected in HIV-infected patients from tropical countries with diarrhea, weight loss, eosinophilia, and low CD4 + cell counts.

Clinical and Laboratory Profile of Children with Eosinophilia at Dhulikhel Hospital

“…For example, in developing countries, many patients with tuberculosis or Isosporiasis and eosinophilia are actually found to be co-infected with helminthes. 8,9 In our case also one patient found to be co infected with tuberculosis and toxocariasis. The diagnosis of eosinophilia in tropical countries presents a difficult problem as parasitic infections are extremely common Original Article among other conditions causing eosinophilia.…”

Isospora belli associated recurrent diarrhea in a child with AIDS

“…Our patient was admitted with malabsorption and weight loss and eosinophil count not exceeded 4 % on average. Study of HIV-infected patients showed that eosinophilia was strongly associated with isosporiasis; however higher eosinophil counts were described in I. belli infected patients without weight loss (Certad et al 2003). This finding could be described that in patients with considerable weight loss the HIV disease is more severe and defect of the immune system may involve the production of eosinophils (Arora and Arora 2009).…”

“…In the latter study I. belli was also seen in 6.3 % (5/ 79) of non-diarrheal cases. In another study of HIV-positive patients (n = 397) diarrhea was reported in 98 % of the cases, of whom 14 % (n = 56) was infected with I. belli (Certad et al 2003). The presence of persistent diarrhea is a common feature of AIDS.…”

HAART and Immune status as predictors of opportunistic enteric coccidian infections in HIV/AIDS patients

“…Similar observation was made by Kumar et al 6 . A contradictory finding was revealed by Certad et al 7 who noted that a significant proportion of patients with Isosporiasis had acute diarrhoea. Gupta et al 8 found Isospora belli in 41.1% of chronic diarrhoea while in the present study Isospora belli was detected in 30 % of HIV positive patients with chronic diarrhoea.…”