Prevalence of intestinal parasitic infections in patients with acquired immunodeficiency syndrome in Brazil

Objectives: To evaluate the prevalence of intestinal parasitic infections and to investigate the possible associations of clinical status and laboratory findings with the different parasites found in stool samples. Methods: Each patient was provided with one standard fecal collection vial containing 10% formalin for detecting ova, larvae, and cysts. To detect Cryptosporidium parvum and Isospora belli, the acid-fast Kinyoun stain and fluorescent auramine-rhodamine stain were used. Results: A total of 200 patients with acquired immunodeficiency syndrome participated in this study; 40% were infected with at least one pathogenic species. The total prevalence of parasites was 16% for Giardia lamblia, 13% for Entamoeba coli, 7% for Cryptosporidium parvum, 3.5% for Endolimax nana, 2.5% for Ascaris lumbricoides, 2.5% for Strongyloides stercoralis, 2% for Isospora belli, and 0.5% for Blastocystis hominis. Results showed that diarrhea was significantly associated with cryptosporidiosis, giardiasis, and isosporiasis. However, no association was observed between the CD4+ cell counts and the manifestation of any particular parasite. Conclusions: The data support the value of standard fecal examinations in human immunodeficiency virus-infected patients, even in the absence of diarrhea, since these examinations easily can be performed, with low costs, and frequently disclose treatable conditions.