1302. Enteric Disease Susceptibility Among HIV Positive Individuals—Philadelphia, PA 2006–2010
Session: Poster Abstract Session: Below the Diaphragm
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • Mehr_Poster_IDWEEK_final.pdf (797.2 kB)
  • Background:

    Enteric pathogens within the immunocompromised host can result in opportunistic infection. While enteric conditions are among the most frequently reportable conditions in Philadelphia their prevalence in HIV infected communities is not well characterized. To further explore co-infection, a cross-sectional analysis of HIV infected individuals with a reported enteric infection from 2006-2010 was performed.

    Methods:

    Cases were defined as being co-infected with HIV and one of the following mandatory reportable enteric pathogens: Salmonella (non-Typhoidal), Shigella, Giardia, Campylobacter, Cryptosporidium, shiga-toxin producing E.coli from 2006-2010. Individuals were identified through a match of Philadelphia Department of Public Health Communicable Disease (PDPH) and HIV/AIDS surveillance databases. Demographic, risk factors and clinical symptoms for these individuals were collected via phone and field interview. Comparison populations consisted of HIV and enteric disease population of Philadelphia without co-infection.

    Results:

    Crude incidence of enteric infection in Philadelphia residents was 259/100000 compared to 803/100000 within the 26,392 HIV infected individuals over the five years. Two hundred and twelve co-infected cases were identified including 64 (30%) salmonellosis, 51 (24%) giardiasis, 47 (22%) cryptosporidiosis, 31 (15%) shigellosis, 18 (8%) campylobacteriosis,  and one (<1%) shiga-toxin producing E. coli co-infected cases. Of the 212 cases, median age was 41 (15-65) years, 76% were male, 77% reported diarrhea, and 41% listed homosexual contact only. Median CD4 counts for cases were 149 vs.  279 for HIV-only individuals (p<0.001). A higher proportion of cases had a viral load >5000 within two years of co-infection (p<.001).  Co-infected cases were hospitalized more than individuals with only an enteric illness (21% vs. 16%, p<.01).

    Conclusion:

    HIV-infected individuals diagnosed with enteric illness present with increased disease severity compared to mono-infected cases. The majority of co-infected cases were male, suggestive that additional research is warranted to further explore fecal-oral transmission via sexual practices.  Increased awareness and education may aid in preventing enteric infections within the HIV infected population.

    Jason Mehr, MPH, Drexel University School of Public Health, Philadelphia, PA, Ami S. Patel, PhD, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Philadelphia, PA, Michael Eberhart, MPH, AIDS Activities Coordinating Office, City of Philadelphia Department of Public Health, Philadelphia, PA, Caroline C. Johnson, MD, Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA and Kathleen Brady, MD, Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA

    Disclosures:

    J. Mehr, None

    A. S. Patel, None

    M. Eberhart, None

    C. C. Johnson, None

    K. Brady, None

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