[Laboratory diagnosis of intestinal micro-parasitosis in AIDS patients: state of the art].

BACKGROUND: The diarrhea, often associated with growing thin and weight loss, is important for nutritional state and quality of life in AIDS patients. It was demonstrated that patients with AIDS who present diarrhea have a greater degree of immunosuppression than those without diarrhea, predisposing the gastrointestinal tract to the action of protozoa, bacterial, viral, fungal pathogens which may cause morbidity and death. HIV-patients are particularly susceptible to protozoa infections. Cryptosporidium infection is among the most common causes of enteric disease but Microsporidium (Enterocytozon bieneusi) and Cyclospora are emerging as potentially important enteric pathogens in AIDS patients. In spite of frequent interest of gastrointestinal tract the knowledge of diarrhea syndromes AIDS-related are often greatly limited by diagnostic difficulties.

OBJECTIVE: A review is made of the different laboratory methods employed in intestinal microparasitosis in the light of considerable dangerousness and aggressiveness of some protozoa on HIV-patients.

METHODS: The methods for the diagnosis of intestinal microparasitosis are based particularly on direct diagnosis (macroscopic or microscopic examination at fresh or after concentration) or an immunological diagnosis.

RESULTS: The laboratory methods available at present permit to evidence different protozoa not evidenced in the past and without invasive techniques.

CONCLUSIONS: The etiological diagnosis of diarrhea in AIDS-patients is often difficult and/or disappointing. Epidemiological knowledge on protozoa pathology has been limited by diagnostic difficulties but their identification is important particularly because an increasing therapeutic regimens are now available to treat these infections.