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Intestinal infections in patients with acquired immunodeficiency syndrome

A prospective study in 132 Patients

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Abstract

We studied prospectively 132 patients with acquired immunodeficiency syndrome to define the spectrum of enteric pathogens during this disease, with special reference to the correlation between the lesions, the infections, and the symptoms. Forty-four percent of the patients harbored at least one enteric pathogen: the most frequently recovered were Cryptosporidium (28), cytomegalovirus (16), Entamoeba histolytica (13), Giardia lamblia (9), and Mycobacterium avium intracellulare (7). Patients harboring pathogens were more likely to be diarrheics (69%) than patients without a pathogen (38%; P=0.01) and more likely to have endoscopic lesions (29%) than patients without a pathogen (4%; P<0.001). The most common pathogen associated with diarrhea was Cryptosporidium. Cytomegalovirus, Entamoeba histolytica, and Salmonella typhimurium were each significantly associated with endoscopic lesions. Patients with cytomegalovirus infection tended to have a greater incidence of ulcer than patients without cytomegalovirus infection. Stool analysis diagnosed 61% of the infections, while endoscopy diagnosed 44%. Seven percent were recognized by stool analysis and endoscopy. When considering the 24 patients in whom accurate diagnosis warranted endoscopic biopsies, stool examination alone would have given an incomplete diagnosis in 14 patients (due to the presence of polyinfection). The frequency of inaccurate diagnosis of infection by stool determination alone, plus the development of new antiviral agents that suppress cytomegalovirus, may favor the earlier application of endoscopic evaluation in these patients.

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Authors and Affiliations

  1. Service de Gastroentérologie, Hôpital Bichat, 46, rue Henri Huchard, 75877, Paris Cedex 18, France

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  2. Laboratory of Pathology, Intensive Care Unit, Department of Infectious Disease, Claude-Bernard Hospital, Paris

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  3. Laboratory of Virology, Claude-Bernard Hospital, Paris

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  4. Laboratory of Bacteriology, Claude-Bernard Hospital, Paris

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  5. Laboratory of Parasitology, Claude-Bernard Hospital, Paris

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  6. Faculty of Medicine Xavier Bichat, INSERM U239, Paris

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

  7. Department of Medical Statistics, Pr. Flamant, Institut Gustave Roussy, 94801, Villejuif Cedex, France

    E. René, C. Marche, B. Regnier, A. G. Saimot, J. L. Vilde, C. Perrone, C. Michon, M. Wolf, Th. Chevalier, Th. Vallot, F. Brun-Vesinet, B. Pangon, A. M. Deluol, F. Camus, C. Roze, J. P. Pignon, M. Mignon & S. Bonfils

Authors
  1. E. René
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  2. C. Marche
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  3. B. Regnier
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  4. A. G. Saimot
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  5. J. L. Vilde
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  6. C. Perrone
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  7. C. Michon
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  8. M. Wolf
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  9. Th. Chevalier
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  10. Th. Vallot
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  11. F. Brun-Vesinet
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  12. B. Pangon
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  13. A. M. Deluol
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  14. F. Camus
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  15. C. Roze
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  16. J. P. Pignon
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  17. M. Mignon
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  18. S. Bonfils
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Additional information

This work was supported in part by Institut National de la Santé et de la Recherche Médicale, (grant UR/010/237) and by Fondation Médicale pour la Recherche, and by Paris VII Faculté.

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René, E., Marche, C., Regnier, B. et al. Intestinal infections in patients with acquired immunodeficiency syndrome. Digest Dis Sci 34, 773–780 (1989). https://doi.org/10.1007/BF01540353

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  • DOI: https://doi.org/10.1007/BF01540353

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