The epidemiology of intestinal microsporidiosis in patients with HIV/AIDS in Lima, Peru

Caryn Bern, Vivian Kawai, Daniel Vargas, Jennifer Rabke-Verani, John Williamson, Raul Chavez-Valdez, Lihua Xiao, Irshad Sulaiman, Aldo Vivar, Eduardo Ticona, Marco Ñavincopa, Vitaliano Cama, Hercules Moura, W. Evan Secor, Govinda Visvesvara, Robert H. Gilman

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


We studied microsporidiosis in human immunodeficiency virus-positive patients in 2 Lima hospitals. Of 2652 patients, 66% were male, 6% received antiretroviral therapy (ART), and the median CD4 lymphocyte count was 131 cells/μL. Sixty-seven patients (3%) had microsporidiosis; stool specimens from 56 were identified as having Enterocytozoon bieneusi of 10 different genotypes. The 2 most common genotypes, Peru-1 and Peru-2, were not associated with significant increases in chronic diarrhea; other genotypes were associated with a 4-fold increased risk. Risk factors for E. bieneusi infection segregated by genotype: contact with duck or chicken droppings and lack of running water, flush toilet, or garbage collection with genotype Peru-1 and watermelon consumption with other genotypes. Shortened survival was associated with low CD4 lymphocyte count (P < .0001), no ART (P < .0001), and cryptosporidiosis (P = .004) but not with microsporidiosis (P = .48). Our data suggest the possibility of zoonotic E. bieneusi transmission and an association with poor sanitary conditions.

Original languageEnglish
Pages (from-to)1658-1664
Number of pages7
JournalJournal of Infectious Diseases
Issue number10
StatePublished - 15 May 2005
Externally publishedYes


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