Kotler D P, Orenstein J M
Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University, New York.
Am J Gastroenterol. 1994 Nov;89(11):1998-2002.
The reported prevalence of enteric pathogens, especially microsporidiosis, in HIV infection varies greatly. In this study, the prevalence rates for microsporidiosis and other enteric pathogens in HIV-infected individuals referred for gastrointestinal symptoms were compared.
This prospective study included 250 HIV-infected individuals (179 with AIDS) who were referred for GI evaluation (diarrhea in 194). The prevalence rates of symptomatic intestinal disease due to microsporidiosis and other intestinal pathogens were determined by clinical evaluation, and their epidemiological, clinical, and immunological characteristics were compared.
Enteric pathogens were identified in 83% of 141 AIDS patients with diarrhea, 2% of 53 AIDS patients without diarrhea, and 3% of 56 non-AIDS patients. Microsporidia was the most common pathogen found (39% of AIDS patients with diarrhea). Two or more coexisting infections were found in 28% of AIDS patients with diarrhea. The prevalence rates for coexisting infections were similar to those predicted from the individual prevalence rates, with the exception of cryptosporidiosis and microsporidiosis, which were lower than predicted. Patients with microsporidiosis had severely depressed CD4 lymphocyte counts in peripheral blood. All patients with microsporidiosis, except one, had diarrhea, and D xylose malabsorption was universal in patients with microsporidiosis.
Microsporidiosis is a common cause of chronic diarrhea, malabsorption, and weight loss in AIDS patients.
据报道，肠道病原体尤其是微孢子虫病在HIV感染中的患病率差异很大。在本研究中，对因胃肠道症状转诊的HIV感染者中微孢子虫病和其他肠道病原体的患病率进行了比较。
这项前瞻性研究纳入了250名因胃肠道评估而转诊的HIV感染者（179名患有艾滋病）（194名有腹泻症状）。通过临床评估确定微孢子虫病和其他肠道病原体所致有症状肠道疾病的患病率，并比较其流行病学、临床和免疫学特征。
在141名有腹泻症状的艾滋病患者中，83%检测出肠道病原体；在53名无腹泻症状的艾滋病患者中，2%检测出肠道病原体；在56名非艾滋病患者中，3%检测出肠道病原体。微孢子虫是最常见的病原体（在有腹泻症状的艾滋病患者中占39%）。在28%有腹泻症状的艾滋病患者中发现两种或更多种合并感染。合并感染的患病率与根据个体患病率预测的结果相似，但隐孢子虫病和微孢子虫病低于预测值。微孢子虫病患者外周血CD4淋巴细胞计数严重降低。除1名患者外，所有微孢子虫病患者均有腹泻症状，且微孢子虫病患者普遍存在D-木糖吸收不良。
微孢子虫病是艾滋病患者慢性腹泻、吸收不良和体重减轻的常见原因。
