Document 0338
 DOCN  M9650338
 TI    Epidemiology of isosporiasis among persons with acquired
       immunodeficiency syndrome in Los Angeles County.
 DT    9605
 AU    Sorvillo FJ; Lieb LE; Seidel J; Kerndt P; Turner J; Ash LR; HIV
       Epidemiology Program, Los Angeles County Department of Health; Services,
       California, USA.
 SO    Am J Trop Med Hyg. 1995 Dec;53(6):656-9. Unique Identifier : AIDSLINE
       MED/96155964
 AB    To determine factors associated with isosporiasis in persons with
       acquired immunodeficiency syndrome (AIDS) in Los Angeles County, data
       from the AIDS surveillance registry were analyzed for the eight-year
       period 1985-1992. Isosporiasis was reported in 127 (1.0%) of 16,351
       persons with AIDS during the study period. Prevalence of infection was
       highest among foreign-born patients (3.2%), especially those from El
       Salvador (7.4%) and Mexico (5.4%), and in all persons of Hispanic
       ethnicity (2.9%). Persons with a history of Pneumocystis carinii
       pneumonia (PCP) were less likely than PCP-negative patients to have
       isosporiasis (0.2% and 1.4%, respectively, P < 0.01). A decrease in the
       prevalence of isosporiasis in patients negative for PCP was observed
       beginning in 1989 (P = 0.02). Prevalence decreased with age (P < 0.01,
       by chi-square test for trend). After controlling for multiple factors by
       logistic regression, isosporiasis was more likely to occur in
       foreign-born patients than in those born in the United States (adjusted
       odds ratio [OR] = 5.8, 95% confidence interval [CI] 3.4, 9.9, P < 0.001)
       and in Hispanics than in whites (non-Hispanics) (adjusted OR = 3.5, 95%
       CI 1.7, 7.2, P < 0.001). A prior history of PCP continued to be
       negatively associated with isosporiasis (adjusted OR = 0.2, 95% CI 0.1,
       0.3, P < 0.001). Age and time remained independently associated with
       infection. These data suggest that isosporiasis among persons with AIDS
       in Los Angeles County may be related to travel exposure and/or recent
       immigration and that the use of trimethoprim-sulfamethoxazole (TMP-SMX)
       for PCP may effectively prevent primary infection or expression of
       latent isosporiasis. Physicians should have an increased index of
       suspicion for Isospora in AIDS patients with diarrhea who have
       immigrated from or traveled to Latin America, among Hispanics born in
       the United States, in young adults, and in those not receiving PCP
       prophylaxis. Food and water precautions should be advised and TMP-SMX
       prophylaxis considered for the prevention of Isospora infection for
       patients with human immunodeficiency virus infection who travel to Latin
       America and other developing countries.
 DE    Adolescence  Adult  Aged  Animal  Antimalarials/THERAPEUTIC USE
       AIDS-Related Opportunistic Infections/DRUG THERAPY/*EPIDEMIOLOGY
       Coccidiosis/DRUG THERAPY/*EPIDEMIOLOGY  Ethnic Groups  Female  Human
       *Isospora  Los Angeles/EPIDEMIOLOGY  Male  Middle Age  Odds Ratio
       Population Surveillance  Prevalence  Registries  Risk Factors
       Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC USE  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).