Lule JR, Mermin J, Malamba S, Ransom R, Hughes P, Downing R, Kizito F, Wafula W, Nakanjako D, Kigozi A, Quick R; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. ThPeC7468.

CDC-Uganda, Entebbe, Uganda

BACKGROUND: Diarrhea is common among persons with HIV infection. Limited data are available on pathogens causing diarrhea among persons with HIV in Africa. We compared the frequency of isolated stool pathogens among persons with and without HIV in rural Uganda. METHODS: Persons with HIV and their household members were enrolled in a household-based, water quality improvement project. On weekly home visits we collected data on diarrhea, defined as >3 loose or watery stools in the past 24 hours, and stool specimens from participants with diarrhea. Stool samples were examined for pathogenic bacteria by culture, and parasites by light microscopy. RESULTS: 452 participants (53% HIV positive) accrued 270 person years of observation (PYO). The bacterial recovery rates from stool were 0.49/PYO in HIV-positive vs 0.30/PYO in HIV-negative participants (RR=1.6, 95% CI=1.1-2.5). Recovery rates of Shigella were higher in HIV positive (0.18/PYO) compared to 0.05/PYO in HIV-negative participants (RR=3.9, 95% CI=1.5-11.4), as were the rates of Aeromonas, 0.12/PYO in HIV positive compared to 0.05/PYO in HIV negative (RR=2.7, 95% CI=1.0-8.2). No difference was observed for Campylobacter and Salmonella. The overall parasite recovery rates were 1.7/PYO in HIV positive compared to 1.2 /PYO in HIV negative (RR=1.3, 95% CI=1.3-1.7). The rates of Cryptosporidia were 0.18/PYO in HIV positive compared to 0.06/PYO in HIV negative (RR=3.0, 95% CI=1.3-7.6), and the rates for Strongyloides Stercoralis were 0.45/PYO in HIV positive compared to 0.21/PYO in HIV negative (RR=2.1, 95% CI=1.3-3.4). CONCLUSION: In this study of persons with diarrhea, those with HIV infection had higher recovery rates of bacterial and parasitic pathogens and higher rates of Shigella, Aeromonas, Cryptosporidia and Strongyloides than persons without HIV. These organisms should be considered when managing people with HIV who present with diarrhea.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Africa
• Diarrhea
• Feces
• HIV Infections
• HIV Seropositivity
• Salmonella Infections
• Uganda

Other ID:

• GWAIDS0017524

UI: 102255022

From Meeting Abstracts