Other parasites rarely encountered in HIVinfected individuals in the North

In contrast to southern Europe and other subtropical areas, AIDS patients in northern Europe rarely acquire Leishmania/HIV co-infection. In Denmark, a single case of untreatable visceral leishmaniasis in an AIDS patient has been described (Balslev et al. 1991). In southern Europe, 25-70% of adult visceral leishmaniasis cases are related to HIV infection (WHO 1997).

With increasing mobility of populations, however, co-infection with HIV and remotely acquired parasitic infections should be remembered. Thus, fulminant, systemic strongyloidiasis has been reported in AIDS (Maayan et al. 1987; Cahill and Shevchuk 1996).

Serious infections with Entamoeba histolytica would be expected to occur in AIDS patients: they do not. Plasmodium falciparum malaria might be expected to interact with HIV infection: it hardly does (Lucas 1990). For more details on exotic parasites occurring in - or surprisingly not occurring in - AIDS, the reader is referred to an excellent review by the British Society for Parasitology and the Royal Society of Tropical Medicine and Hygiene (1990).

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