PubMed · 10278425
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J Kosterlitz. 1986-08-30. Educating about AIDS.. https://pubmed.ncbi.nlm.nih.gov/10278425/
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Previous studies from African countries where HIV-1 infection is prevalent have shown that infections with Cryptosporidium parvum, Isospora belli and microsporidia are frequently associated with chronic diarrhoea in AIDS patients. The information about the occurrence of these parasites in HIV-2 associated AIDS cases with chronic diarrhoea is limited. We have performed a study of stool parasites in patients from Guinea-Bissau, the country with the highest prevalence of HIV-2 in the world. Stool specimens from 52 adult patients with chronic diarrhoea of which 37 were HIV-positive and fulfilling the clinical criteria of AIDS (five HIV-1, 28 HIV-2 and four dually infected with HIV-1 and HIV-2) were screened for parasitic infections. Twenty five percent of the HIV-2 positive patients were infected with C. parvum, 11% with I. belli and 11% with microsporidia, all three parasites were seen only in HIV-positive patients. The three patients with microsporidiosis, all HIV-2 infected, are to our knowledge the first cases reported from Guinea-Bissau. Other stool parasites such as Blastocystis hominis, hookworm and Strongyloides stercoralis were observed both among HIV-positive and HIV-negative patients.
To determine whether AIDS surveillance misses a substantial number of persons who die with unreported AIDS, we conducted a cross-sectional survey of decedents examined by the San Francisco (SF) Medical Examiner. Decedents who received toxicology screening were tested for HIV antibody and examined for evidence of AIDS. Names of decedents with positive or indeterminate HIV antibody test results were cross-referenced against the SF AIDS registry to identify previously reported AIDS cases. Medical records of unreported cases were reviewed to determine whether AIDS had been diagnosed prior to death. Of 1959 decedents tested, 176 (9%) were HIV positive; 105 (60%) were identified as having AIDS by the Medical Examiner. Of the 105 AIDS cases, 101 (96%) had been previously diagnosed; 98 (97%) had been previously reported. Overall, diagnosis and reporting were 93% complete. HIV-infected decedents were more likely than those uninfected to be men and <45 years old, and less likely to be Asian/Pacific Islander or Native American (p <.001). They were more likely to have died of suicide (p <.05) or drug abuse/overdose (p <.001). In SF, AIDS case reporting is highly complete. Current surveillance activities, which identify cases from health care settings, are appropriate. To decrease deaths among HIV-infected persons, suicide prevention and substance abuse treatment programs are needed.