HIV Digest	HIV Digest Archive

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Parasites pose a diagnostic problem, since many do not present symptoms but cause hidden damage. San Francisco AIDS specialist Jon Kaiser suggests that all people with HIV receive annual screening for parasites. Dr. Kaiser says that as many of 30 percent of his new patients test positive for parasites.

When the B cells of the intestinal lining are depleted due to immunosuppression, the body becomes an ideal breeding ground for parasites. While protease inhibitors have generally decreased the rate of parasitic infections, reconstituted CD4 cells may not be able to adequately fight off parasites. Cryptosporidium and Microsporidium are two types of protozoa that can cause opportunistic infections and primarily affect people with low CD4 counts.

Diagnosis of a parasitic infection includes knowledge of risky behavior, CD4 counts below 150, waxing and waning of stool consistency, and use of immunosuppressant drugs. Definitive diagnosis, however, requires analysis of a stool specimen. Flagyl is the primary drug used to treat parasitic infections; but because the drug can be toxic to the liver, some doctors are also using herbal remedies.

Editor's Note: from POZ