Campylobacter jejuni and HIV infection

OBJECTIVE: To evaluate the characteristics of the Campylobacter jejuni infection in HIV positive patients. DESIGN: We report all cases appeared in our hospital between September 1991 and October 1992 with: HIV infection, chronic diarrhoea and C. jejuni in stool culture. Epidemiologic factors, other opportunist infections, immunologic situation, clinical symptomatology, antibiotic sensitivity and evolution are recorded. RESULTS: Six patients, 4 men and 2 women, with an average age of 38 years were recorded. They have different risk factors (drug abusers, sexual behaviour and haemophilia). Chronic liver disease and other opportunist infections of the gastrointestinal tract were the most important facts in past history. CD4 count were directly related with the severity of the illness. Quantitative or qualitative disorders of B lymphocytes or immunoglobulins were not found. All of term suffered from chronic diarrhoea with fever in four of them and bacteremia in 2 patients. First generation cephalosporins resistance in one occasion. A good evolution occurred in 3 patients, another had a relapse and bacteremia appeared in 2 patients whose CD4 count were lower of 100/mm3, have AST, ALT changes and other concomitant gastrointestinal infections. CONCLUSION: C. jejuni infection of the gastrointestinal tract results in chronic diarrhoea with a higher incidence than expected in HIV positive patients. The severity is directly related with CD4 count, and the existence of concomitants infections of the gastrointestinal tract or chronic liver disease. Antibiotic resistance to macrolide is possible, especially in chronic and severe forms.