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February 1991

Association Between the Acquired Immunodeficiency Syndrome and Infection With Salmonella typhi or Salmonella paratyphi in an Endemic Typhoid Area

Author Affiliations

From the Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana "Cayetano Heredia" (Drs Gotuzzo, Sanchez, and Carrillo), and the Instituto Peruano de Seguridad Social "Edgardo Rebagliati" (Drs Frisancho and Liendo), Lima, Peru; and the Department of International Health, The Johns Hopkins University School of Hygiene and Public Health (Dr Black),and the Division of Geographic Medicine, Department of Medicine, and the Center for Vaccine Development, University of Maryland School of Medicine (Dr Morris), Baltimore, Md.

Arch Intern Med. 1991;151(2):381-382. doi:10.1001/archinte.1991.00400020125026

Eight cases of typhoid and paratyphoid fever were identified during a 4-year period in a cohort of 117 patients who were positive for human immunodeficiency virus in Lima, Peru. Asymptomatic patients with human immundeficiency virus infection and patients with the lymphadenopathy syndrome had a typical clinical presentation and response to therapy. Patients with the acquired immunodeficiency syndrome who were culture positive for Salmonella typhi or Salmonella paratyphi presented with fulminent diarrhea and/or colitis; the two patients for whom at least 2 months of follow-up were available relapsed. In our cohort there were 0.06 cases of typhoid or paratyphoid per patient year of observation; this rate is approximately 60 times that in the general population in Lima, and 25 times that in the 15- to 35-year-old age group. Our data indicate that patients who are positive for human immunodeficiency virus are at significantly increased risk for infection with S typhi and S paratyphi, and suggest that the clinical presentation of these diseases in patients with the acquired immunodeficiency syndrome differs from that seen in immunocompetent hosts.

(Arch Intern Med. 1991;151:381-382)