TY - JOUR
T1 - Diarrhea and Clostridium difficile infection in Latin American patients with AIDS
AU - Willingham, Field F.
AU - Chavez, Eduardo Ticona
AU - Taylor, David N.
AU - Bowen, Anna B.
AU - Crane, Andrea R.
AU - Gottlieb, Aren L.
AU - Gayles, Michael K.
AU - Grahn, Kirstin F.
AU - Perez, Victor Manuel Chavez
AU - Apolinario, Ines Salas
AU - Gilman, Robert H.
N1 - Funding Information:
Received 14 October 1997; revised 17 April 1998. Financial support: National Institutes of Health (grant no. U01-AI35894-03), World AIDS Federation (grant no. 94,093), and the RG-ER Fund. Reprints or correspondence: Dr. Robert Gilman, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, 615 North Wolfe Street, Baltimore, Maryland 21205. * Working Group members are listed at the end of the text.
PY - 1998
Y1 - 1998
N2 - Diarrhea and wasting are among the most debilitating and deadly manifestations of AIDS, yet only limited information is available regarding the etiology, clinical consequences, and immunologic effects of infection with diarrheal agents. Peruvian AIDS patients presenting with and without diarrhea were followed prospectively to examine the relations among diarrheal pathogens, clinical presentations, CD4 lymphocyte count, weight loss, and survival. Patients with chronic diarrhea had lower CD4 lymphocyte counts (P = .001) and lost more weight (P < .001). Weight loss and a decreased CD4 lymphocyte count were associated with increased mortality (P = .011 and P = .003, respectively). Mean CD4 lymphocyte count varied significantly by diarrheal agent. Clostridium difficile was the most prevalent pathogen and was associated with significantly increased mortality before and after adjustment for coinfection, length of follow-up, CD4 lymphocyte count, and weight loss (P = .006). C. difficile may be a more important and more prevalent etiologic agent in AIDS than previously recognized and may represent a preventable cause of death in patients with immunosuppression.
AB - Diarrhea and wasting are among the most debilitating and deadly manifestations of AIDS, yet only limited information is available regarding the etiology, clinical consequences, and immunologic effects of infection with diarrheal agents. Peruvian AIDS patients presenting with and without diarrhea were followed prospectively to examine the relations among diarrheal pathogens, clinical presentations, CD4 lymphocyte count, weight loss, and survival. Patients with chronic diarrhea had lower CD4 lymphocyte counts (P = .001) and lost more weight (P < .001). Weight loss and a decreased CD4 lymphocyte count were associated with increased mortality (P = .011 and P = .003, respectively). Mean CD4 lymphocyte count varied significantly by diarrheal agent. Clostridium difficile was the most prevalent pathogen and was associated with significantly increased mortality before and after adjustment for coinfection, length of follow-up, CD4 lymphocyte count, and weight loss (P = .006). C. difficile may be a more important and more prevalent etiologic agent in AIDS than previously recognized and may represent a preventable cause of death in patients with immunosuppression.
UR - http://www.scopus.com/inward/record.url?scp=17344365787&partnerID=8YFLogxK
U2 - 10.1086/514688
DO - 10.1086/514688
M3 - Article
C2 - 9770145
AN - SCOPUS:17344365787
SN - 1058-4838
VL - 27
SP - 487
EP - 493
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -