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may be the only manifestation of acanthamebiasis, or it may precede additional organ
involvement by weeks or months.[540]

MALARIA AND AIDS.-- Malaria is endemic to parts of Africa and Asia where the
prevalence of HIV infection is 1% or more of the population. The presence of HIV infection
appears to increase the incidence of parasitemia with Plasmodium falciparum infection, which
can lead to more clinically evident malaria and severe malaria. Malaria may increase viral load
and decrease CD4 counts, affecting the course of HIV infection and transmission rates of HIV.
HIV-infected patients have higher rates of malaria treatment failures.[541]

ZOONOTIC DISEASE AND AIDS.-- There are a number of infections that occur in
patients with HIV that can potentially be transmitted from animal sources. The agents include
Cryptosporidium, Microsporidium, Campylobacter jejuni, Giardia lamblia, Salmonella species
(not typhi), Rhodococcus equi, Bartonella henselae, and Listeria monocytogenes. Of these, only
Bartonella appears to be acquired in patients with HIV infection mainly from an animal source
(cat). Even so, the risk for zoonotic transmission of any infection to an HIV-infected person is
small. The benefits of animal companionship outweigh the risks to patients and prohibition of
pet ownership by HIV-infected persons is not warranted.[542]