Association between amebic liver abscess and Human Immunodeficiency Virus infection in Taiwanese subjects

Among ALA patients, the proportion of HIV-positive individuals increased during the study period. ALA was the first major clinical presentation in 54% of HIV patients with ALA. Overall, 58% (14/24) of HIV-infected patients had a CD4+ count > 200 cells/μL and 82.1% (23/28) had no concurrent opportunistic infection or other evidence of HIV infection. There was no marked difference in clinical characteristics between HIV-positive and HIV-negative ALA patients except the level of leukocytosis.While the clinical characteristics described herein cannot be used to determine whether ALA patients have HIV infection, routine HIV testing is recommended in patients with ALA, even in the absence of HIV symptoms.Amebiasis, a parasitic infection caused by Entamoeba histolytica, is transmitted by ingestion of food or water containing the cyst form of the parasite, and results in amebic colitis and the formation of amebic liver abscess (ALA). Amebiasis is one of the most infectious diseases in the world with developing countries, including Central and South America, tropical Asia, and Africa, as areas of highest incidence. In developed countries, individuals at increased risk for amebiasis include immigrants from developing countries, travelers to the tropics, residents of institutions for mentally retarded individuals, homosexual men, and immunodepressed individuals. Patients with advanced human immunodeficiency virus (HIV) represent one of the highest risk groups of invasive amebiasis [1,2]. Luminal agents such as paromomycin, diloxanide furoate, and iodoquinol are typically used for the treatment of amebiasis caused by E. histolytica infection [1].ALA is the most common extraintestinal manifestation of E. histolytica infection. E. histolytica transmission is associated with the oral-fecal pathway and is facilitated by poor sanitary conditions [3]. Traveling to endemic areas, with the possibility of ingesting contaminated food or water, remains a risk for contracting ALA. In Taiwa