ИСТИНА

Microsporidia were identified in stool specimens by light microscopy and PCR in 30 (18.9%) of 159 HIV-infected patients presenting to the S.P. Botkin Memorial Clinical Hospital of Infectious Diseases, St. Petersburg, Russia. Unexpected was the higher prevalence of Encephalitozoon intestinalis in 21 (12.8%) patients compared to Enterocytozoon bieneusi in two patients (1.2%). Encephalitozoon cuniculi was detected in three patients; one with strain I and two with strain II. Encephalitozoon hellem was detected in one patient, and two patients were identified with Microsporidium species. One patient was infected with both E. intestinalis and E. cuniculi. In two patients, the microsporidia species were not identified. No statistically significant differences in gender, age, and stage of AIDS were observed between the microsporidia-positive and -negative HIV-infected patients. Patients diagnosed with microsporidia were significantly more likely to exhibit < 100 CD4+ T cells/mL blood (P = 0.01) and weight loss > 10% (P = 0.04) than patients not diagnosed with microsporidia . Cryptosporidia were detected in 17 of total 99 (17.2%) patients by PCR and light microscopy. Сriprtosporidium parvum was diagnosed in eleven (64,7%), C. hominis – in six patients (35,3%) by RFLP, verified by direct sequencing. Patients with cryptosporidiosis demonstrated lower average CD4+ lymphocytes numbers (P = 0.05) and increased frequency of long lasted (>10 days) diarrhea (P = 0.06). This is the first report describing the diagnosis of microsporidia in HIV-infected patients in Russia, and the first detection of E. cuniculi strain II in a human. Prevailing Encephalitozoon intestinalis and Cryptosporidium parvum over Enterocytozoon bieneusi and C. hominis might suggest zoonotic rout of infection in the studied patient group. Supported by CRDF (RUB2-002707-SP-05), RFBR (10-04-00943), NIH (RR 00164), and Tulane Research Enhancement Fund.