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Multimethodological Approach to Gastrointestinal Microsporidiosis in HIV-Infected Patients

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Abstract

Purpose

Microsporidiosis is an opportunistic infection that produces chronic diarrhoea and cholangiopathy in patients with AIDS, mainly caused by two species of microsporidia, Enterocytozoon bieneusi and Encephalitozon intestinalis. The aim of this work was to develop an integral system for the diagnosis of microsporidiosis of the intestine and biliary tract in HIV-infected patients, comprising microscopic and molecular techniques.

Methods

The study population comprised 143 adult patients of both sexes with diagnosis of HIV infection, with chronic diarrhoea, and with or without HIV-associated cholangiopathy. Stool studies for microsporidia identification of spores were performed on each patient. A video esofagogastroduodenoscopy with biopsy collection was also carried out for routine histology and semi-thin sections stained with Azure II. Species identification was carried out by transmission electron microscopy and/or polymerase chain reaction for the species E. bieneusi and E. intestinalis.

Results

Out of the 143 patients a total of 12.6% (n = 18) were infected with microsporidia. Microsporidia species identified in most cases was E. bieneusi (16/18 cases), followed by E. intestinalis (4/18), all of these last ones in coinfection with E. bieneusi.

Conclusions

Clinical, imaging, microscopic and molecular analyses, when applied in a systematic and integrated approach, allow diagnosis and identification of microsporidia at species level in AIDS patients with chronic diarrhoea, and with or without HIV-associated cholangiopathy.

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Authors and Affiliations

  1. Hospital Municipal de Infecciosas “Dr. Francisco Javier Muñiz”, Uspallata 2272, CP 1282, Buenos Aires, Argentina

    Jorge Néstor Velásquez

  2. Hospital Municipal General de Agudos “Dr. José María Penna”, Pedro Chutro 3380, CP 1437, Buenos Aires, Argentina

    Cecilia di Risio & Cristina Etchart

  3. Instituto Nacional de Enfermedades Infecciosas, ANLIS “Dr. Carlos G. Malbrán”, Avenida Vélez Sársfield 563, CP 1281, Buenos Aires, Argentina

    Agustín Víctor Chertcoff, Osvaldo Germán Astudillo & Silvana Carnevale

  4. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina

    Silvana Carnevale

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  1. Jorge Néstor Velásquez
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  2. Cecilia di Risio
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  3. Cristina Etchart
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  4. Agustín Víctor Chertcoff
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  5. Osvaldo Germán Astudillo
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  6. Silvana Carnevale
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Correspondence to Jorge Néstor Velásquez.

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Velásquez, J.N., di Risio, C., Etchart, C. et al. Multimethodological Approach to Gastrointestinal Microsporidiosis in HIV-Infected Patients. Acta Parasit. 64, 658–669 (2019). https://doi.org/10.2478/s11686-019-00095-z

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