Symptoms of infectious diseases in HIV-positive travellers: A prospective study with exposure-matched controls.

Abstract:

BACKGROUND:Recently, the number of HIV-infected travellers to (sub)tropical areas has increased substantially. In the Netherlands, HIV-positive travellers with CD4-cells of <500/mm3 are advised to carry stand-by antibiotic treatment against travellers' diarrhoea. Our aim was to determine whether HIV infection is associated with travel-related symptomatic diseases. METHODS:A prospective study was performed among HIV-infected travellers and age-matched HIV-uninfected travel companions serving as controls, attending two travel clinics in Amsterdam. Participants filled out daily questionnaires before, during, and after their trip. RESULTS:Overall, 52 pairs were included. All participants were male, and 91.3% were born in a Western country. Prevalence of travel-related diarrhoea was 50% among HIV-positive travellers and 40% among controls. No significant differences were observed for incident travel-related diarrhoea (incidence rate ratio = 1.60, 95%CI = 0.79-3.27) or duration of symptoms (odds ratio = 1.49, 95%CI = 0.65-3.45). There were no significant differences in symptom incidence or duration for travel-related vomiting, cough, rhinitis, pruritus, fatigue, or nausea. Only 6.3% of HIV-positive travellers with CD4-cells of <500/mm3 and diarrhoea used their stand-by antibiotic treatment as recommended. CONCLUSION:Travel-related symptoms were not significantly more frequent or longer lasting among HIV-infected travellers compared to controls. Most HIV-infected travellers with CD4-cells of <500/mm3 and diarrhoea did not take stand-by antibiotic treatment. These results may question the need for routine prescription of stand-by antibiotics among this specific risk group. Further research, especially among HIV infected VFR travellers and in larger study groups is needed.

journal_name

Travel Med Infect Dis

authors

Suryapranata F,Boyd A,Grobusch MP,Prins M,Sonder G

doi

10.1016/j.tmaid.2019.01.003

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

28-33

eissn

1477-8939

issn

1873-0442

pii

S1477-8939(19)30003-1

journal_volume

29

pub_type

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