Common health problems in HIV-infected travelers to the (sub)tropics

Background: A study was conducted to estimate the incidence of health problems in HIV-infected travelers with various degrees of immunodeficiency to the (sub)tropics. Methods: A retrospective questionnaire-based study among HIV-infected patients attending the outpatient department of a university hospital during three months in 1996 with a history of travel to (sub)tropical destinations in the preceeding 12 months. The outcome measures were incidences of and medical consultation rates for common travel-associated illnesses. Results: Of 293 HIV-infected patients, 59 (20%) had traveled during the preceding 12 months; of these 36 (61%) responded. Ten (28%) had traveled more than once during this period. There were no significant differences between travelers and nontravelers regarding CD4 count and age. Fifteen respondents (42%) used cotrimoxazole (CTX) for PCP prophylaxis; 22 (61%) had sought pretravel health advice. Median duration of travel was 3 weeks. Respiratory infections were recorded by two respondents (6%, 95% confidence intervals 1-19%) and skin problems by 10 (28%, 14-45%). Of 31 respondents without diarrhea on departure, 10 recorded diarrhea (32%, 19-57%). The overall rate of medical consultation for travel-related complaints was 5% abroad and 28% after return, respectively. There was no association between the risk of diarrhea and CD4 count or CTX prophylaxis, even after adjustment for differences in age, duration of travel and travel experience. Conclusions: Although numbers in this study are small, HIV-infected travelers tend to have a high rate of medical consultation for (possibly) travel-related illness. Diarrhea is the most frequent complaint, but shows no strong association with degree of immunodeficiency.