Isosporiasis in patients with HIV infection in the highly active antiretroviral therapy era in France
Article first published online: 31 JAN 2008
© 2008 British HIV Association
Volume 9, Issue 2, pages 126–130, February 2008
How to Cite
Lagrange-Xélot, M., Porcher, R., Sarfati, C., De Castro, N., Carel, O., Magnier, J.-D., Delcey, V. and Molina, J.-M. (2008), Isosporiasis in patients with HIV infection in the highly active antiretroviral therapy era in France. HIV Medicine, 9: 126–130. doi: 10.1111/j.1468-1293.2007.00530.x
- Issue published online: 31 JAN 2008
- Article first published online: 31 JAN 2008
- Received: 7 September 2007, accepted 2 November 2007
- sub-Saharan Africa
Isosporiasis, a rare cause of diarrhoea among HIV-infected patients in the pre-highly active antiretroviral therapy (HAART) era, seems to be re-emerging.
A retrospective study was carried out for the period 1995–2003 in two hospitals in Paris to describe the prevalence, clinical characteristics and therapeutic outcome of isosporiasis in HIV-infected patients, and to compare the findings with those for cryptosporidiosis and microsporidiosis.
The prevalence of isosporiasis increased from 0.4 per 1000 patients in the pre-HAART era (1995–1996) to 4.4 per 1000 patients in the HAART era (2001–2003), whereas the prevalence of cryptosporidiosis and microsporidiosis decreased. Compared with patients with either cryptosporidiosis (n=91) or microsporidiosis (n=58), patients with isosporiasis (n=28) more frequently originated from sub-Saharan Africa (72%), were more frequently female and heterosexual, and had a higher median CD4 count at diagnosis (142 cells/μL). All patients with isosporiasis presented with diarrhoea, which was severe enough to lead to hospital admission for 60% of them. Fever was uncommon (7%). All patients were treated for isosporiasis, 27 of them with cotrimoxazole. Relapse of isosporiasis occurred in six of 16 patients (38%) despite maintenance cotrimoxazole therapy and HAART.
Isosporiasis in France occurs mostly in patients emigrating from sub-Saharan Africa and can induce severe diarrhoea. Relapse is common despite cotrimoxazole maintenance therapy.