The utility of screening for parasitic infections in HIV-1-infected Africans with eosinophilia in London

Abstract

The presence of asymptomatic eosinophilia in HIV patients has been demonstrated to have a wide variety of causes. Untreated parasitic infections in immunocompromised individuals can have potentially serious consequences. The utility of screening for parasitic infections in immigrant HIV-positive Africans with eosinophilia was investigated in a UK-based HIV clinic. HIV-positive African patients with eosinophilia were matched with HIV-positive African controls without eosinophilia. More than half of African HIV patients with eosinophilia had positive parasitic serology, and were significantly more likely to have positive serology compared with African HIV patients without eosinophilia. This study shows that asymptomatic eosinophilia in HIV-1-infected Africans is strongly suggestive of underlying parasitic infection. Individuals with eosinophilia should thus be screened for parasitic infections according to the infections prevalent in the countries they have lived in or visited for substantial periods of time.

Intestinal Parasitoses in HIV Infected Children in a Nigerian Tertiary Hospital

“…More than 85% of children studied with and without intestinal helminths had eosinophilia thus the differences in these two groups were not statistically significant. The results obtained from this study were consistent with other studies and they also suggest the possibility of concurrent infections with helminths [23,24]. The low prevalence of helminths in the present study however suggested that the aetiology of eosinophilia in HIV infected individuals might be due to other aetiologies than helminths.…”

Eosinophilia in returning travellers and migrants from the tropics: UK recommendations for investigation and initial management

“…2,3,10 Human immunodeficiency virus (HIV) infection may also present with eosinophilia, although helminth co-infection is still a more likely cause in this setting. 11 Eosinophilia has numerous non-infectious causes. Common non-infectious causes include drugs (non-steroidal anti-inflammatory drugs, beta-lactam antibiotics, nitrofurantoin and others), atopy (asthma, eczema and hay fever) and allergy.…”

The Changing Face of Canadian Immigration: Implications for Infectious Diseases

“…In an HIV-infected population in the United Kingdom, screening for eosinophilia and parasites was undertaken in patients of African origin (18). Among the 51 patients with eosinophilia, 55% had positive parasite serology compared with 9% of control African HIV patients without eosinophilia.…”

“…Thus, eosinophilia was a good marker for parasitic infection. However, 37% of patients with positive schistosomal serology had normal eosinophil counts when screened, indicating that infection may be present in the absence of eosinophilia (18). Microscopic diagnosis was made in only one of 89 specimens sent (47 urines and 42 stools), indicating poor test characteristics.…”