Etiologies and Manifestations of Persistent Diarrhea in Adults with HIV‐1 Infection: A Case‐Control Study in Lima, Peru

Cárcamo, César; Hooton, Thomas M.; Wener, Mark H.; Weiss, Noel S.; Gilman, Robert H.; Arévalo, Jorge; Carrasco, José Ángel Gómez; Seas, Carlos; Caballero, Martin; Holmes, King K.

doi:10.1086/426508

Cited by 73 publications

(78 citation statements)

References 40 publications

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“…In a study in adult HIV patients in Lima, ETEC accounted for 4% of all the diarrhea cases. 1 In a study conducted in Brazil of HIV-infected children less than 13 years of age, there was one EPEC strain isolated and no ETEC in diarrheal samples, however, the number of samples was very small. 19 In a study in HIV-infected infants from Zaire, ETEC was isolated in 11% of diarrhea cases and EPEC in 15%.…”

Section: Discussionmentioning

confidence: 98%

“…Diarrhea in patients infected with the human immunodeficiency virus (HIV) continues to be a common problem in developing countries, 1,2 particularly in places where highly active antiretroviral treatment (HAART) is not widely available and where opportunistic infections continue to be a common problem. The lifetime incidence of diarrhea among HIV patients has been estimated to be 30% to 70%.…”

Section: Introductionmentioning

confidence: 99%

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Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Medina¹,

Rivera²,

Romero³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted a prospective study in three hospitals in Lima in human immunodeficiency virus (HIV) children to determine the frequency of diarrheagenic Escherichia coli. Five E. coli colonies/patients were studied by a multiplex real-time polymerase chain reaction to identify the six currently recognized groups of diarrhea-associated E. coli . We have analyzed 70 HIV-associated diarrheal and 70 control samples from HIV-infected children without diarrhea. Among the diarrheal episodes 19% were persistent, 3% dysenteric, and 33% were associated with moderate or severe dehydration. The diarrheagenic E. coli were the most commonly isolated pathogens in diarrhea (19%) and control samples (26%) ( P = 0.42), including enteroaggregative (6% versus 10%), enteropathogenic (6% versus 10%), and enterotoxigenic E. coli (4% versus 3%), respectively. The HIV-infected children with diarrhea had the worse age-related immunosuppression, higher viral loads, and were on highly active antiretroviral treatment (HAART) less often than HIV-infected children without diarrhea . Diarrheagenic E. coli were highly resistant to ampicillin (74%) and cotrimoxazole (70%).

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Medina¹,

Rivera²,

Romero³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Symptoms of giardiasis in HIV-infected individuals appear to be similar to, and no more severe than, those of giardiasis in HIV-negative individuals, with asymptomatic infection occurring commonly in the presence of HIV (39,196). With progressive immunosuppression following reduced CD4 ϩ counts, the risk of symptomatic Giardia infections is increased (12,79).…”

Section: Giardia Intestinalismentioning

confidence: 92%

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

et al. 2009

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SUMMARY Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to date that either affect humoral immunity or compromise T-cell function. All individuals affected by immunosuppression are at risk of infection by opportunistic parasites (such as the microsporidia) as well as those more commonly associated with gastrointestinal disease (such as Giardia). The outcome of infection by enteric protozoan parasites is dependent on absolute CD4+ cell counts, with lower counts being associated with more severe disease, more atypical disease, and a greater risk of disseminated disease. This review summarizes our current state of knowledge on the significance of enteric parasitic protozoa as a cause of disease in immunosuppressed persons and also provides guidance on recent advances in diagnosis and therapy for the control of these important parasites.

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“…In both developing and developed countries, EAEC affects both adults and children (609,611,632,(653)(654)(655). It also causes acute and persistent diarrhea in HIV-infected patients (612,656,657) and persistent diarrhea in children, which leads to growth and intellectual shortfalls (as reviewed in references 585 and 658). The most significant public health concern stemming from EAEC infections is malnourishment in children in developing countries, as persistent EAEC infections lead to chronic inflammation, which damages the intestinal epithelium and reduces its ability to absorb nutrients (585,(618)(619)(620)(658)(659)(660).…”

Section: Clinical Considerationsmentioning

confidence: 99%

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

et al. 2013

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SUMMARY Although Escherichia coli can be an innocuous resident of the gastrointestinal tract, it also has the pathogenic capacity to cause significant diarrheal and extraintestinal diseases. Pathogenic variants of E. coli (pathovars or pathotypes) cause much morbidity and mortality worldwide. Consequently, pathogenic E. coli is widely studied in humans, animals, food, and the environment. While there are many common features that these pathotypes employ to colonize the intestinal mucosa and cause disease, the course, onset, and complications vary significantly. Outbreaks are common in developed and developing countries, and they sometimes have fatal consequences. Many of these pathotypes are a major public health concern as they have low infectious doses and are transmitted through ubiquitous mediums, including food and water. The seriousness of pathogenic E. coli is exemplified by dedicated national and international surveillance programs that monitor and track outbreaks; unfortunately, this surveillance is often lacking in developing countries. While not all pathotypes carry the same public health profile, they all carry an enormous potential to cause disease and continue to present challenges to human health. This comprehensive review highlights recent advances in our understanding of the intestinal pathotypes of E. coli .

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Etiologies and Manifestations of Persistent Diarrhea in Adults with HIV‐1 Infection: A Case‐Control Study in Lima, Peru

Cited by 73 publications

References 40 publications

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Diarrheagenic Escherichia coli in Human Immunodeficiency Virus (HIV) Pediatric Patients in Lima, Perú

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

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