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Among them, Enterocytozoon bieneusi and Encephalitozoon spp. are the most clinically relevant species. We investigated the occurrence and genetic diversity of microsporidial and protist infections in mostly immunocompetent HIV-positive patients in Madrid, Spain. A structured questionnaire was used to retrieve data on factors potentially associated with an increased risk of infection, including sexual attitudes and sex-risk behaviour. Faecal samples (n = 96) from 81 HIV-positive patients were collected and analysed by molecular (PCR and Sanger sequencing) methods. Two microsporidial pathogens were detected: Ent. bieneusi (2.5%, 95% CI: 0.3\u20138.6) and Enc.intestinalis (4.9%, 95% CI: 1.4\u201312.2). The two Ent. bieneusi isolates were identified as zoonotic genotype A. Among protists, Entamoeba dispar was the species most prevalently found (33.3%, 95% CI: 23.2\u201344.7), followed by Blastocystis spp. (19.8%, 95% CI: 11.7\u201330.1), Giardia duodenalis (13.6%, 95% CI: 7.0\u201323.0), and Cryptosporidium spp. and Entamoeba histolytica (2.5%, 95% CI: 0.3\u20138.6 each). Cyclospora cayetanensis and Cystoisospora belli were not detected. Subtypes ST1 (70.6%, 12\/17) and ST3 (29.4%, 5\/17) were identified within Blastocystis sp., sub-assemblages AII and BIII (50%, 1\/2 each) within G. duodenalis, and Cry. parvum and canine-adapted Cry. canis (50%, 1\/2 each) within Cryptosporidium spp. Microsporidial and protist parasites were frequent in well-controlled, mostly immunocompetent HIV-positive patients and should be included in diagnostic algorithms when diarrhoea is present.<\/jats:p>","DOI":"10.1093\/mmy\/myad039","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T01:07:38Z","timestamp":1680829658000},"source":"Crossref","is-referenced-by-count":18,"title":["<i>Enterocytozoon bieneusi<\/i> and <i>Encephalitozoon intestinalis<\/i> (microsporidia) in HIV-positive patients in central Spain"],"prefix":"10.1093","volume":"61","author":[{"given":"Mercedes","family":"Chozas","sequence":"first","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Dashti","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Prieto-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-3208","authenticated-orcid":false,"given":"Ram\u00f3n","family":"P\u00e9rez-Tanoira","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, University Hospital Pr\u00edncipe de Asturias , Meco, Madrid , Spain"},{"name":"Department of Biomedicine and Biotechnology, Faculty of Medicine, Alcal\u00e1 de Henares University , Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cobo","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Bailo","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"del\u00a0Palacio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Hern\u00e1ndez-Castro","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"},{"name":"Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia , Medell\u00edn, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5083-8854","authenticated-orcid":false,"given":"David","family":"Gonz\u00e1lez-Barrio","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4015-8553","authenticated-orcid":false,"given":"David","family":"Carmena","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , Spain"},{"name":"Centre for Biomedical Research Network (CIBER) in Infectious Diseases, Health Institute Carlos III , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela C","family":"K\u00f6ster","sequence":"additional","affiliation":[{"name":"Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III , Majadahonda, Madrid , 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