Screening African HIV positive patients for imported parasitic infections.

Objectives: To assess the results of screening for tropical parasitic infections in HIV patients from Africa, presenting to an infectious diseases unit in the UK.

Methods: A retrospective case note review of patients from Sub-Saharan Africa, newly diagnosed with HIV infection, between March 2001 and November 2007. Data on patient demographics, clinical presentation and laboratory results, including tropical screening tests, were collected.

Results: 146 patients had notes available for review. 22 different countries were represented. 84 patients were screened, by serology, for schistosomiasis, strongyloidiasis, filariasis and leishmaniasis. 13/122 (10.7%) patients tested had positive schistosomiasis serology and 2/107 (1.9%) had positive strongyloidiasis serology. No patients had positive Leishmania (n = 108) or filaria (n = 97) serology. 3 of 38 (7.9%) had stool samples that were positive for pathogens. Positive schistosomiasis serology was associated with male sex (61.5% vs 28.4% p < 0.05) and a higher mean eosinophil count (0.46 vs 0.12 cells/microL p < 0.0001).

Conclusion: Screening HIV patients from Sub-Saharan Africa for schistosomiasis in this population, was positive in over 1 in 10 patients. We would recommend screening for schistosomiasis in these patients. Our results do not support serological screening for leishmaniasis or filarial infection in these patients.