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Background. Toxoplasmosis-related hospitalizations often occur in persons with human immunodeficiency virus (HIV) infection and other causes of immunosuppression. Methods. Using the National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project, we examined trends in toxoplasmosis-related hospitalizations by HIV infection status from 1993 through 2008, and rates by sex and race or ethnicity in 2008. The NIS is designed to represent a 20% sample of US community hospitals and currently includes information on up to 8 million discharges per year from 1000 hospitals. We used International Classification of Diseases, Ninth Revision, Clinical Modification codes 130-130.9 for toxoplasmosis and 042-044/795.8/795.71/V08 for HIV infection. Results. Estimated HIV-associated toxoplasmosis hospitalizations increased from 9395 in 1993 to 10 583 in 1995 (P =.0002), then dropped to 3643 in 2001 (P < .0001), with similar levels thereafter. The rate of HIV-associated toxoplasmosis hospitalizations among all HIV-related hospitalizations decreased from 3.33% in 1993 to 1.25% in 2008 (P <.0001). Estimated non-HIV-associated toxoplasmosis hospitalizations were less variable from 1993 to 2008 (range, 386-819; 0.0020% in 1993, 0.0015% in 2008). In 2008, the rates of both HIV- and non- HIV-associated toxoplasmosis hospitalizations were higher in Hispanic persons than in white persons. Conclusions. HIV-associated toxoplasmosis hospitalizations dropped markedly after 1995 when highly active antiretroviral therapy was introduced; however, hospitalizations decreased relatively little after 2000, suggesting late diagnosis of some HIV-infected persons or antiretroviral therapy failure. Non-HIV-associated toxoplasmosis hospitalizations have been more stable. The rates of toxoplasmosis-related hospitalizations varied markedly among racial and ethnic groups. [ABSTRACT FROM AUTHOR]

Background. To describe trends in bacterial diarrhea among human immunodeficiency virus (HIV)-infected persons during 1992-2002, we examined data from a longitudinal record review study of persons with HIV infection who were receiving medical care in 1100 medical facilities in 9 major United States cities. Methods. An analysis was performed using data from 44,778 persons who were followed up for a mean of 2.6 years. We calculated incidence rates and rate ratios for bacterial diarrhea, by stage of HIV disease, and determined odds ratios (ORs) to compare bacterial diarrhea diagnosis in 2002 versus 1992. Results. The mean annual incidence of bacterial diarrhea was 7.2 cases per 1000 person-years. The incidence of Clostridium difficile-associated diarrhea, the most common bacterial cause of diarrhea, was 4.1 cases per 1000 person-years. Compared with persons without AIDS, persons with AIDS were more likely to have bacterial diarrhea (incidence rate ratio, 1.3-9.9, varying by clinical versus immunologic AIDS and type of bacterial diarrhea). Between 1992 and 2002, the overall rate of bacterial diarrhea in persons with clinical AIDS decreased (OR, 0.4; 95% confidence interval, 0.2-0.6). During the same period, bacterial diarrhea rates among other persons in the analysis did not significantly change. Conclusions. C. difficile is the most common recognized cause of bacterial diarrhea among persons infected with HIV. The risk for bacterial diarrhea increases with increased severity of HIV disease. Health care professionals should be aware that patients with AIDS are at increased risk for bacterial diarrhea, and they should reinforce recommendations for decreasing the chances of acquiring bacterial diarrhea. [ABSTRACT FROM AUTHOR]

Presents a study on the incidence of aspergillosis among HIV-infected people and survival after aspergillosis diagnosis by use of national HIV surveillance database. Information on aspergillosis; Methods; Results and discussion.

WI-1, a 120-kD protein found in the outer cell wall of Blastomyces dermatitidis, has been purified, labeled with 125I, and used as a target in a radioimmunoassay (RIA). In an assessment of the usefulness of anti-WI-1 serology in the diagnosis of blastomycosis, the RIA was used to test four panels of sera from residents of Wisconsin, a state in which blastomycosis is endemic. Twenty-four (75%) of 32 patients whose blastomycosis had been reported to the Wisconsin Division of Health had at least one serum sample positive for antibody to WI-1; 25 (93%) of 27 serum samples obtained from these patients within 60 days of diagnosis were positive. In an effort to simulate clinical practice, 132 serum samples were assayed from another 107 patients in whom blastomycosis was being considered as a cause of illness. The result was positive for at least one sample from 83% of the 23 patients with confirmed blastomycosis and from 5% of the 84 patients from whom the fungus was not documented. Serum samples from another five patients with blastomycosis identified during investigation of a 1990 outbreak in Oconto Falls, Wisconsin, also gave a positive result, whereas none of the serum specimens from 57 healthy family members or neighbors did so. Only three (0.56%) of 535 serum samples from random blood donors residing in two counties with a high annual incidence of blastomycosis were positive for antibody to WI-1. Modification of the RIA so that IgM rather than IgG antibody was detected did not enhance diagnostic sensitivity. We conclude that anti-WI-1 serological testing is very useful for the diagnosis of blastomycosis in an endemic area. [ABSTRACT FROM PUBLISHER]

The article offers information on the Toxoplasma gondii and Toxocara Species in the U.S. It mentions Toxoplasma gondii is a protozoan parasite and Toxocara is an intestinal nematode, both share ingestion of contaminated soil as means of exposure in humans; and also mentions the results suggest that exposure to both Toxoplasma gondii and Toxocara is common in the United States and could be explained through a common route of exposure of ingestion of contaminated soil.