Enteric Infections and Diarrhea in Human Immunodeficiency Virus–Infected Persons

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Abstract
DIARRHEA IS frequently stated to cause substantial morbidity and mortality in persons infected with human immunodeficiency virus (HIV), occurring at some time during the illness in up to 60% of patients in industrialized nations and in up to 90% of patients in developing countries.1-3 However, few systematic data on the epidemiology of diarrhea and intestinal infections are available.4 Most reports are based on cross-sectional data of selected or small patient groups, and the reported prevalence rates of different intestinal pathogens vary widely.4 Recently, a changing epidemiological and clinical pattern of opportunistic complications was observed in industrialized countries that was explained by the influence of chemoprophylaxis and antiretroviral therapy, but little is known as to whether these interventions also had an impact on enteric infections. Furthermore, practical questions regarding the diagnostic approach of HIV-associated diarrhea, in particular the intensity of the diagnostic workup, remain unanswered or controversial.4-9

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