ABSTRACT
The interactions between human immunodeficiency virus (HIV) and parasitic infections are important for several reasons. The natural history of parasitic infections in persons with HIV/acquired immunodeficiency syndrome (AIDS) may be altered due to incompetent immune response, at times leading to extraordinary manifestations of even the most common of infestations. In persons with HIV infection, the severity and atypicality of the presentation is correlated with the immune status and CD4 count. Persons with HIV are more susceptible to developing infection after inoculation of the parasite by the vector, tend to develop more severe disease, and have more recurrences after treatment than immunocompetent persons. In persons with immunocompromise due to HIV, several atypical forms may develop, perhaps due to the fact that both agents infect monocytes and macrophages. In any AIDS patient with a nonhealing cutaneous lesion, evaluation should include cultures for bacteria, mycobacteria, fungi, and Bartonella.
