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A cross-sectional study was undertaken to determine the prevalence of isosporiasis and its clinical and laboratory pattern in Venezuelan patients infected with human immunodeficiency virus (HIV) (n = 397). At enrollment, they underwent a thorough clinical history and physical examination, and provided stool specimens for the identification of Isospora belli and other parasites. Isospora belli was identified in 56 subjects (14%) and diarrhea, either acute or chronic, was present in 98% of these cases (P < 0.001). Eosinophilia was strongly associated with isosporiasis (P = 0.01). It was also found that the presence of eosinophilia was more common in I. belli-infected patients without weight loss (P < 0.001). Twenty-six (81.25%) subjects with I. belli infection had CD4+ cell counts < 200 cells/mm3 (P = 0.03). In addition, the data and its description shows the association to be < 100 cells/mm3. This infection seems to be seasonal because the recovery of oocysts occurred mainly in months with significant rainfall. In fact, isosporiasis should be suspected in HIV-infected patients from tropical countries with diarrhea, weight loss, eosinophilia, and low CD4+ cell counts.
Received January 27, 2003. Accepted for publication May 29, 2003.
Acknowledgments: We thank Isbelia Rada for expert laboratory assistance. The authors also wish to thank the American Committee on Clinical Tropical Medicine and Travelers Health (ACCTMTH) for assistance with publication expenses.
Financial support: This study was supported by a grant from the Consejo de Desarrollo Cientifico y Humanistico of the Universidad Central de Venezuela.
Authors’ addresses: Gabriela Certad, Alejandro Arenas-Pinto, Leonor Pocaterra, Giuseppe Ferrara, Andreina Bello, and Luz Nuñez, Cátedra de Parasitología, Escuela de Medicina José María Vargas, Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela. Julio Castro, Unidad de Investigación Quirúr-gica, Hospital Vargas de Caracas, San José, Caracas, Venezuela.
Reprint requests: Gabriela Certad, Cátedra de Parasitología, Escuela de Medicina José María Vargas, Facultad de Medicina, Universidad Central de Venezuela, San José, Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: gfombo{at}cantv.net.
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