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European Journal of Epidemiology

, Volume 13, Issue 4, pp 485–487 | Cite as

Giardiasis in HIV: A possible role in patients with severe immune deficiency

  • Gioacchino Angarano
  • Paolo Maggi
  • Maria Assunta Di Bari
  • Angela Maria Vittoria Larocca
  • Pierpaolo Congedo
  • Cesare De Bari
  • Olga Brandonisio
  • Francesco Chiodo
Article

Abstract

We report the epidemiological, clinical and therapeutic characteristics of giardiasis in a population of HIV-infected patients with diarrhoic syndrome. During the period between 1988 and 1995, 720 HIV-patients with diarrhoic syndrome were evaluated. Fecal specimens were submitted to parasitological examination according to the Ritchie formalin-ethil acetate centrifugal sedimentation method and stained with iodine. Samples also underwent modified Ziehl-Neelsen staining and standard bacteriologic testing. Cystis of G. intestinalis were identified in stool sample of 25 patients. Two patients were classified as in stage A2 and 23 in C3. Mean CD4 values of patients with giardiasis (26.9 cells/mmc) were compared with those of 65 patients from whom, during the study, was isolated Cryptosporidium parvum (63.12, cells/mmc): the difference resulted highly significant (p < 0.001). Among the patients with full-blown AIDS, giardiasis occurred following a single previous AIDS-defining event in 13 inividuals, in seven and in five subjects giardiasis was the 3rd and, respectively, the 4th relevant AIDS-defining condition. Death occurred within the following 2 months in nine patients and within 6, 12 and 24 months in seven, six and two patients, respectively; at present only three AIDS patients are still alive. In general, G. intestinalis in HIV+, is not considered a major cause of enteritis; nevertheless, in our experience enteritis due to G. intestinalis is a frequent event among AIDS patiens, especially in the most advanced stage of disease, irrespectively of the risk factor. The increase in mean survival of AIDS patients will probably lead to a progressive emergence of this pathogen which could determine a severe diarroic syndrome with hydroelectrolytic impairments.

AIDS Giardia intestinalis HIV infection 

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References

  1. 1.
    Chui DW, Owen RL. AIDS and the gut. J Gastroenterol Hepatol 1994; 9: 291–303.Google Scholar
  2. 2.
    DuPont HL, Marshall GD. HIV-associated diarrhoea and wasting. Lancet 1995; 346: 352–356.Google Scholar
  3. 3.
    Fine KD, Krejs GJ, Fordtran JS. Diarrhea. In: Sleisenger MH, Fordtran JS (eds), Gastrointestinal Disease. Philadelphia, Pa: WB Saunders, 1989.Google Scholar
  4. 4.
    Van Laethem G. Manifestations digestive chez les patients HIV+. Acta Urologica Belgica 1993; 61: 1–7.Google Scholar
  5. 5.
    Laughon BE, Druckman DA, Vernon A, Quinn TC, Polk BF, Modlin JF, Yolken RH, Bartlett JG. Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome. Gastroenterology 1988; 94: 984–993.Google Scholar
  6. 6.
    Fauci AS, Rosemberg ZF. Immunopathogenesis. In: Broder S, Merigan Jr TC, Bolognesi D (eds), Textbook of AIDS medicine. Baltimore: William and Wilkins, 1994: 55–75.Google Scholar
  7. 7.
    Lane HC, Masur H, Edgar LC, Whalen G, Rook AH, Fauci AS. Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome. N Engl J Med 1983; 309: 453–458.Google Scholar
  8. 8.
    Amadori A, De Rossi A, Faulkner-Valle GP, Chieco-Bianchi L. Spontaneous in vitro production of virus-specific antibodies by lymphocytes from HIV-infected subjects. Clin Immunol Immunopathol 1988; 46: 342–351.Google Scholar
  9. 9.
    Reddy MM, Goetz RR, Gorman JM, Grieco MH, Cheb L, Lederman S. Human immunodeficiency virus type-1 infection in homosexual men is accompanied by a decrease in circulating B cells. J Acq Immune Def Syn 1991; 4: 428–434.Google Scholar
  10. 10.
    Kats IR, Krown SE, Safai B, Oettgen HF, Hoffman MK. Antigen-specific and polyclonal B-cell responses in patients with acquired immunodeficiency disease. Clin Immunol Immunopathol 1986; 39: 359–367.Google Scholar
  11. 11.
    Amadori A, Chieco-Bianchi L. B-cell activation and HIV-1 infection: deeds and misdeeds. Immunol Today 1990; 11: 374–379.Google Scholar
  12. 12.
    Heyworth MF. Immunology of Giardia and Cryptosporidium infections. J Infect Dis 1992; 166: 465–472.Google Scholar

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Gioacchino Angarano
    • 1
  • Paolo Maggi
    • 1
  • Maria Assunta Di Bari
    • 2
  • Angela Maria Vittoria Larocca
    • 3
  • Pierpaolo Congedo
    • 4
  • Cesare De Bari
    • 4
  • Olga Brandonisio
    • 5
  • Francesco Chiodo
    • 2
  1. 1.Institutes of Infectious DiseaseUniversity of BariItaly
  2. 2.Institute of Infectious DiseaseUniversity of BolognaItaly
  3. 3.Institutes of HygieneUniversity of BariItaly
  4. 4.Department of Infectious DiseaseGeneral Hospital of BrindisiItaly
  5. 5.Institutes MicrobiologyUniversity of BariItaly

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