Journal Article

Etiology of Chronic Diarrhea in Antiretroviral-Naive Patients with HIV Infection Admitted to Norodom Sihanouk Hospital, Phnom Penh, Cambodia

Senya Chhin, Joseph I. Harwell, Joanna D. Bell, Gregory Rozycki, Tom Ellman, J. Mark Barnett, Honorine Ward, Steven E. Reinert and David Pugatch

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 7, pages 925-932
Published in print October 2006 | ISSN: 1058-4838
Published online October 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/507531
Etiology of Chronic Diarrhea in Antiretroviral-Naive Patients with HIV Infection Admitted to Norodom Sihanouk Hospital, Phnom Penh, Cambodia

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Background. Although both human immunodeficiency virus (HIV) infection and diarrhea are considerable problems in Cambodia, there have not been any studies to determine the history, clinical presentation, and etiology of chronic diarrhea in patients with HIV infection in Cambodia. In this article, we present a case-control study involving 40 HIV-infected patients with chronic diarrhea and 40 HIV-infected patients without diarrhea.

Methods. Clinical, demographic, and laboratory data were collected. Stool samples were examined for parasites, including Cryptosporidium species (by partial acid-fast stain), bacterial pathogens, and rotavirus. Samples from 10 case patients and 10 control subjects were also analyzed for Cryptosporidium species by polymerase chain reaction-restriction fragment-length polymorphism.

Results. The median CD4+ cell count was 11.5 cells/mm3. A potential pathogen was found in 30 case patients (75%) and 29 control subjects (72.5%). Cryptosporidium was the most common pathogen, present in 16 case patients (40%) and 20 control subjects (53.3%). The presence of Cryptosporidium was confirmed by polymerase chain reaction-restriction fragment-length polymorphism, with a prevalence of 40% in each of the 2 groups of 10 subjects who were enrolled for Cryptosporidium evaluation.

Conclusions. Subjects in this cohort had severe immunosuppression. The prevalence of pathogens, including Cryptosporidium, was extremely high but did not differ significantly between the case patients with diarrhea and the control subjects without diarrhea. Further studies are needed to examine factors associated with Cryptosporidium carriage and the natural history of asymptomatic infection.

Journal Article.  4289 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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