Giardia intestinalis diarrhea in a HIV-positive patient with Pneumocystis jiroveci pneumonia, as a possible symptom of IRIS.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) still have a detrimental effect on public health. Lack of adequate therapy inevitably leads to the decrease in lymphocyte T CD4+ population and emergence of opportunistic infections (OIs) and AIDS-indicators. Pneumocystis jiroveci pneumonia (PjP) is recognized as one of the most common OIs in people living with HIV. Giardia intestinalis is a protozoan parasite, commonly reported throughout the world as the most important non-viral cause of human diarrhea. Immunocompromised patients are a high risk group for parasitic infections. Giardiosis usually is self-limiting, however it can cause severe dehydration and malnutrition, especially in immunocompromised individuals. In this work we described a case of 46-year old men, who stoped ART and expanded IRIS symptoms due to PjP and Giardia intestinalis infections. We concluded that parasitic stool examination in HIV/AIDS individuals should be performed to detect asymptomatic protozoa infections, which can lead to diarrhea during ARV treatment. Moreover, determination of the IRIS risk factors may have a detrimental effect on the prevention of severe complications in patients living with AIDS.