Parasitic Infections Associated with HIV/AIDS in the Caribbean

This review article seeks to highlight the significance for the Caribbean of major parasitic infections associafed with AIDS, encourage awareness of these opportunistic parasites, and promote familiarity with appropriate diagnostic techniques and their clinica relevance. Spe-cific agents considered include Pneumocystis carinii; Toxoplasma gondii; the enferic coccidiuns Cryptosporidium spp., Isospora belIi, and Cyclospora cayetanensis; the hemoflagellates Leishmania spp. and Trypanosoma cruzi; the fungi Histoplasma cap-sulatum and Cryptococcus neoformans; the nematode Strongyloides stercoralis; and the mife Sarcoptes scabiei. These disease agents can be divided into two groups, the immune-regulated ‘endogenous” parasites (the protozoans P. carinii and T. gondii, and possibly the roundworm S. ster-corak) and intracellular parasifes (including the enteric coccidia, hemoflagellates, and fungi). Both in the Caribbean and ezsewhere, the endogenous parasites (particularly P. carinii and T. gondii) are the most troublesome for AIDS patients, partry because they are likely to be transmitted and establish a benign immunoregulated presence early in the subject’s life. Indeed, health management programs for AIDS patients often routinely include P