Tropical diseases screening in immigrant patients with human immunodeficiency virus infection in Spain

Abstract

Latent parasitic infections can reactivate because of immunosuppression. We conducted a prospective observational study of all human immunodeficiency virus (HIV)-infected immigrants who visited the Infectious Diseases Department of the Hospital Universitari Vall d'Hebron, Barcelona, Spain, during June 2010-May 2011. Screening of the most prevalent tropical diseases (intestinal parasitosis, Chagas disease, leishmaniasis, malaria, schistosomiasis, and strongyloidiasis) was performed according to geographic origin. A total of 190 patients were included: 141 (74.2%) from Latin America, 41 (21.6%) from sub-Saharan Africa, and 8 (4.2%) from northern Africa. Overall, 36.8% (70 of 190) of the patients had at least one positive result for any parasitic disease: 5 patients with positive Trypanosoma cruzi serology, 11 patients with positive Schistosoma mansoni serology, 35 patients with positive Strongyloides stercoralis serology, 7 patients with positive Leishmania infantum serology, intestinal parasitosis were detected in 37 patients, malaria was diagnosed in one symptomatic patient. We propose a screening and management strategy of latent parasitic infections in immigrant patients infected with HIV.

Figure 1.

Geographic origin of patients in the study in Spain. Numbers represent number of patients coming from each country.

Figure 2.

Screening and management strategy of latent parasitic infections in human immunodeficiency virus–infected patients in Spain. LA = Latin America; SSA = sub-Saharan Africa. *Patients from Brazil, Venezuela, Surinam, and Caribbean islands. †Eosinophilia, pruritus, suggestive skin lesions, and gastrointestinal disorders. ‡Eosinophilia, hematuria, and suggestive ultrasound disorders.