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In the STI supplement I this year, 80th MSSVD Spring Meeting held jointly with the 19th STI Congress of IUSTI Europe, the following abstract was omitted from the printed abstract book, with apologies to the authors.
Incidence and causes of peripheral eosinophilia in HIV-1 infected individuals attending a district general hospital
L. Sarner1, A. Fakoya1, C. Tawana1, A. Copas2, P. Chiodini3, K. Fenton2. 1The Greenway Centre, Newham General Hospital, London, UK; 2Department of STDs The Royal Free Hospital & UCL Medical School, Mortimer Market Centre, London, UK; 3Department of Parasitology, Mortimer Market Centre, London
Objectives: To determine the incidence of eosinophilia in a cohort of HIV-1 positive individuals and to compare the prevalence of positive parasite serology between African cases and controls.
Methods: Patients attending an inner city HIV clinic with peripheral eosinophilia (⩾0.5×109/l) on two or more occasions were identified as cases from a retrospective review of haematological records from October 1999 to August 2001. Controls (Africans without eosinophilia) were obtained from an ongoing prospective study. Demographic and clinical data were ascertained by case notes review and patient questionnaire. Investigations for parasitic infections were undertaken (schistosomal, filarial, and strongyloides serology).
Results:295 patients had haematological tests during the observation period, of which 67 (23%) had peripheral eosinophilia. 60/67 (90%) of the cases were of African origin, the mean nadir CD4 count was 193 and 25% were stage CDC C. Controls (n=45) were broadly similar. To date, 26/45 (58%) African cases had positive serological screens for parasites (23 schistosomal, 4 strongyloides, and 2 filarial infections), compared with 4–45 (9%) of controls (4 schistosomal infections) p<0.001, χ2test. There was no positive serology in 3/7 non-African cases screened.
Conclusions: Although previous studies have demonstrated a low incidence of parasitic infection in HIV-1 positive patients with eosinophilia, we have identified a high number of treatable parasitic causes. No cause has been identified in 42%, suggesting that for a proportion of these HIV may be the cause. Despite this, routine screening for parasitic infection, guided by geographical exposure, is recommended in HIV-1 infected Africans with eosinophilia.
The following acknowledgement was omitted from the original article entitled Chlamydial infection: an accurate model for opportunistic screening in general practice, by Verhoeven, Avonts, Meheus et al(Sex Transm Infect 2003;79:313–317): We would like to thank Eddy Van Dyck and Hilde Smet from the Prince Leopold Institute of Tropical Medicine, Antwerp, for their help with setting up the diagnostic protocol and for performing confirmation tests, Joost Weyler of Antwerp University for his statistical advice, and all participating GPs in the field. This work was partly supported by Eurogenerics, the Scientific Organisation of Flemish GPs (WVVH), and the Local Health Promotion Organization (LOGO) of Antwerp. The sponsors of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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