       Document 0591
 DOCN  M9650591
 TI    Blastocystis hominis in human immunodeficiency virus-related diarrhea.
 DT    9605
 AU    Albrecht H; Stellbrink HJ; Koperski K; Greten H; Medical Outpatient and
       Inpatient Clinics, Eppendorf University; Hospital, Hamburg, Germany.
 SO    Scand J Gastroenterol. 1995 Sep;30(9):909-14. Unique Identifier :
       AIDSLINE MED/96117868
 AB    BACKGROUND: A wide variety of bacterial, viral, and parasitic pathogens
       can cause severe diarrhea in patients with advanced human
       immunodeficiency virus (HIV) infection. Conflicting evidence exists as
       to whether Blastocystis hominis should also be included among the
       infectious agents capable of causing HIV-related diarrhea. METHODS: We
       determined the prevalence and clinical significance of B. hominis in a
       cohort of 262 patients with HIV infection, presenting at the infectious
       diseases department of a tertiary referral university hospital in
       northern Germany. RESULTS: B. hominis was detected in stool samples of
       99 patients (38%). The isolation rate varied highly between the
       different groups. Homosexual men (43%; odds ratio (OR), 2.1; p = 0.01)
       had a higher detection rate than patients from other risk groups (26%),
       and patients with acquired immunodeficiency syndrome (46%; OR, 1.8; p =
       0.03) were more likely to carry B. hominis than patients in earlier
       stages of their HIV infection (32%). An association with clinical
       symptoms was not evident. Presence of B. hominis, however, was
       frequently associated with the concurrent isolation of other enteric
       pathogens or apathogenic parasites. CONCLUSIONS: The data suggest that
       the isolation of B. hominis does not justify treatment even in
       symptomatic, severely immunocompromised patients. Most patients will
       either have spontaneous resolution of symptoms or successful
       identification of other infectious or noninfectious etiologies. Therapy
       should be limited to patients with persistent unexplained symptoms after
       a thorough evaluation and a complete screening for alternative
       etiologies, including the use of endoscopic procedures and the careful
       examination of multiple specimens.
 DE    Adolescence  Adult  Aged  Analysis of Variance  Animal  AIDS-Related
       Opportunistic Infections/EPIDEMIOLOGY/*PARASITOLOGY  Blastocystis
       hominis/*ISOLATION & PURIF  Blastocystis
       Infections/DIAGNOSIS/*EPIDEMIOLOGY  Cohort Studies
       Diarrhea/EPIDEMIOLOGY/*PARASITOLOGY  Feces/PARASITOLOGY  Female  Germany
       Human  Incidence  Male  Middle Age  Odds Ratio  Risk Factors  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

