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Enteric disease susceptibility among HIV positive individuals
Thesis

Enteric disease susceptibility among HIV positive individuals

Jason Mehr
Master of Public Health (M.P.H.), Drexel University
May 2012
DOI:
https://doi.org/10.17918/etd-3957
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Mehr_Jason_20121.07 MB
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Abstract

Enteric Diseases HIV-Positive Persons Public Health
Background: HIV positive individuals have compromised immune systems, leading to an increased morbidity of disease. Enteric pathogens are the most common form of communicable disease the Philadelphia Department of Public Health (PDPH) investigates. This presents a serious risk to the HIV positive population of Philadelphia. Objective: Conduct a cross-sectional analysis of the susceptibility of HIV positive individuals to enteric pathogens from 2006-2010. Methods: Cases were defined as being co-infected with HIV and one of the following mandatory reportable enteric pathogens from between 2006-2010: Salmonella (non-Typhoidal), Shigella, Giardia, Campylobacter, Cryptosporidium, shiga-toxin producing E.coli. Comparison populations consisted of the general HIV and enteric disease population of Philadelphia. Results: From 2006-2010 18 (8%) campylobacteriosis, 64 (30%) salmonellosis (non-Typhoidal), 31 (15%) shigellosis, 47 (22%) cryptosporidiosis, 1 (<1%) shiga-toxin producing E. coli and 51 (24%) giardiasis cases of co-infection were reported. Of the 212 co-infected cases, 76% were male, 77% reported having diarrhea, and 41% listed as having homosexual contact only. Cases had a mean CD4 count of 242 as opposed to a mean CD4 count of 356 for the HIV-only group. Regression showed that Male-Male sexual contact could be associated with enteric disease status (OR 1.7, 95% CI 1.17, 2.53). Conclusion: Comparison of CD4 counts and viral loads between co-infected cases and the HIV positive only comparison group depicted more severe HIV infection among the co-infected. Results suggest men who have sex with men may not only risk infecting partners with HIV during sexual activity, but enteric diseases as well.

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