Volume 76, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


A prospective, comparative study of the prevalence of enteric protozoa was determined among human immunodeficiency virus (HIV)– positive and HIV-negative men who have sex with men (MSM) in Sydney, Australia. A total of 1,868 patients submitted stool specimens; 1,246 were from MSM (628 HIV positive and 618 HIV positive) and 622 from non-MSM were examined over a 36-month period. A total of 651 (52.2%) stool specimens from MSM were positive for protozoa compared with 85 (13%) from non-MSM. There was a significant difference in the prevalence of , , , , , and detected between MSM and non-MSM ( < 0.001). The only notable difference between HIV-negative and HIV-positive MSM was that HIV-infected MSM were found to more likely have a infection. was found in 3 patients, in 25, and in 17, all of whom were MSM. When compared with a control group, MSM were significantly more likely to harbor intestinal protozoa and have multiple parasites present. The results of this study show high rates of enteric parasites persist in MSM and highlight the importance of testing for intestinal parasites in MSM. This is the first report of from MSM.


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  1. Peters CS, Sable R, Janda WM, Chittom AL, Kocka FE, 1986. Prevalence of enteric parasites in homosexual patients attending an outpatient clinic. J Clin Microbiol 24 : 684–685.
  2. Levine GI, 1991. Sexually transmitted parasitic diseases. Prim Care 18 : 101–128.
  3. Pakianathan MR, McMillan A, 1999. Intesinal protozoa in homosexual men in Edinburgh. Int J STD AIDS 10 : 780–784.
  4. Markell EK, Havens RF, Kuritsubo RA, Wingerg J, 1984. Intestinal protozoa in homosexual men of the San Francisco Bay area: prevalence and correlates of infection. Am J Trop Med Hyg 32 : 239–245.
  5. Tsaihong JC, Liou MY, Ma PC, 1993. Enteric parasites and antibodies to human immunodeficiency virus in homosexual men with diarrhoea. Gaoxiong Yi Xue Ke Xue Za Zhi 9 : 567–571.
  6. Stark D, Beebe N, Marriott D, Ellis JT, Harkness J, 2005. Detection of Dientamoeba fragilis in fresh stool specimens using PCR. Int J Parasitol 35 : 57–62.
  7. Troll H, Marti H, Weiss N, 1997. Simple differential detection of Entamoeba histolytica and Entamoeba dispar in fresh stool specimens by sodium acetate-acetic acid-formalin concentration and PCR. J Clin Microbiol 35 : 1701–1705.
  8. Ali IK, Hossain MB, Roy S, Ayeh-Kumi PF, Petri WA Jr, Haque R, Clark CG, 2003. Entamoeba moshkovskii infections in children, Bangladesh. Emerg Infect Dis 9 : 580–584.
  9. Law CL, Walker J, Qassim MH, 1999. Factors associated with the detection of Entamoeba histolytica in homosexual men. Int J STD AIDS 2 : 346–350.
  10. Van Gool T, Snijders F, Reiss P, Eeftinck Schattenkerk JK, van den Bergh MA, Weerman MA, Bartelsman JF, Bruins JJ, Canning EU, Dankert J, 1993. Diagnosis of intestinal and disseminated microsporidial infections in patients with HIV by a new rapid fluorescence technique. J Clin Pathol 46 : 694–699.
  11. Garcia LS, 2001. Diagnostic Medical Parasitology. Washington, DC: American Society for Microbiology Press, 746–749.
  12. Ortega HB, Borchardt KA, Hamilton R, Ortega P, Mahood J, 1984. Enteric pathogenic protozoa in homosexual men from San Francisco. Sex Transm Dis 11 : 59–63.
  13. Stolte IG, Duckers NH, Geskus RB, Coutinho RA, de Wit JB, 2004. Homosexual men change to risky sex when perceiving less threat of HIV/AIDS since availability of highly active antiretroviral therapy: a longitudinal study. AIDS 18 : 303–309.
  14. Ohnishi K, Kato Y, Imamura A, Fukayama M, Tsunoda T, Sakaue Y, Sakamoto M, Sagara H, 2004. Present characteristics of symptomatic Entamoeba histolytica infection in the big cities of Japan. Epidemiol Infect 132 : 57–60.
  15. Clark CG, Diamond LS, 1991. The Laredo strain and other ‘Entamoeba histolytica like’ amoebae are Entamoeba moshkovskii. Mol Biochem Parasitol 46 : 11–18.
  16. Haque R, Ali IKM, Akther S, Petri WA Jr, 1998. Comparison of PCR, isoenzyme analysis, and antigen detection for diagnosis of Entamoeba histolytica infection. J Clin Microbiol 36 : 449–452.
  17. Parija SC, Khairnar K, 2005. Entamoeba moshkovskii and Entamoeba dispar-associated infections in Pondicherry, India. J Health Popul Nutr 23 : 292–295.
  18. Solaymani-Mohammadi S, Rezaian M, Babaei Z, Rajabpour A, Meamar AR, Pourbabai AA, Petri WA Jr, 2006. Comparison of a stool antigen detection kit and PCR for diagnosis of Entamoeba histolytica and Entamoeba dispar infections in asymptomatic cyst passers in Iran. J Clin Microbiol 44 : 2258–2261.
  19. Nozaki T, Motta SR, Takeuchi T, Kobayashi S, Sargeaunt PG, 1989. Pathogenic zymodemes of Entamoeba histolytica in Japanese male homosexual population. Trans R Soc Trop Med Hyg 83 : 525.
  20. O’Sullivan B, Delpech V, Pontivivo G, Karagiannis T, Marriott D, Harkness J, McAnulty J, 2002. Shigellosis linked to sex venues, Australia. Emerg Infect Dis 8 : 862–864.
  21. Mirelman D, Nuchamowitz Y, Stolarsky T, 1997. Comparison of use of enzyme-linked immunosorbent assay-based kits and PCR amplification of rRNA genes for simultaneous detection of Entamoeba histolytica and E. dispar. J Clin Microbiol 35 : 2405–2407.
  22. Gonin P, Trudel L, 2003. Detection and differentiation of Entamoeba histolytica and Entamoeba dispar isolates in clinical samples by PCR and enzyme-linked immunosorbent assay. J Clin Microbiol 41 : 237–241.
  23. Visser LG, Verweij JJ, van Esbroek M, Edelinh WM, Clerinx J, Polderman AM, 2006. Diagnostic methods for differentiation of Entamoeba histolytica and Entamoeba dispar in carriers: performance and clinical implications in a non-endemic setting. Int J Med Microbiol 296 : 397–403.
  24. Haque R, Neville LM, Hahn P, Petri WA Jr, 1995. Rapid diagnosis of Entamoeba infection by using Entamoeba and Entamoeba histolytica stool antigen detection kits. J Clin Microbiol 33 : 2558–2561.
  25. Furrows SJ, Moody AH, Chiodini PL, 2004. Comparison of PCR and antigen detection methods for diagnosis of Entamoeba histolytica infection. J Clin Pathol 57 : 1264–1266.
  26. Doyle PW, Helgason MM, Mathias RG, Proctor EM, 1990. Epidemiology and pathogenicity of Blastocystis hominis. J Clin Microbiol 28 : 116–121.
  27. Ali SA, Hill DR, 2003. Giardia intestinalis. Curr Opin Infect Dis 16 : 453–460.
  28. Stark D, Beebe N, Marriott D, Ellis JT, Harkness J, 2005. A prospective study on the prevalence, genotyping and clinical relevance of Dientamoeba fragilis infections in an Australian population. J Clin Microbiol 43 : 2718–2723.
  29. Norberg A, Nord CE, Evengard B, 2003. Dientamoeba fragilis: a protozoal infection which may cause severe bowel distress. Clin Microbiol Infect 9 : 65–68.
  30. Vandenberg O, Peek R, Souayah H, Dediste A, Buset M, Scheen R, Retore P, Zissis G, van Gool T, 2006. Clinical and micro-biological features of dientamoebiasis in patients suspected of suffering from a parasitic gastrointestinal illness: a comparison of Dientamoeba fragilis and Giardia lamblia infections. Int J Infect Dis 10 : 255–261.
  31. Pozio E, Morales MAG, 2005. The impact of HIV-protease inhibitors on opportunistic parasites. Trends Parasitol 21 : 58–63.
  32. Monkemuller KE, Call SA, Lazenby AJ, Wilcox CM, 2000. Declining prevalence of opportunistic gastrointestinal disease in the era of combination antiretroviral therapy. Am J Gastroenterol 95 : 457–462.
  33. Hiatt RA, Markell EK, Ng E, 1995. How many stool examinations are necessary to detect pathogenic intestinal protozoa? Am J Trop Med Hyg 53 : 36–39.

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  • Received : 20 Aug 2006
  • Accepted : 07 Nov 2006

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