Relationship Between Human Immunodeficiency Virus Infection and Salmonellosis in 20- to 59-Year-Old Residents of New York City

Among 20- to 59-year-old residents of New York City who have septicemia, gastroenteritis, urinary tract infection, and multiple site infections due to Salmonella, those listed in the New York City AIDS Registry were highly overrepresented. Among the patients listed in the registry, males outnumbered females by 4:1 (septicemia), 9:1 (multiple site infections), 5.6:1 (gastroenteritis), and 2.5:1 (urinary tract infection); among patients not listed, males outnumbered females by 2.7:1 (septicemia), 3:1 (multiple site infections), 1.2:1 (gastroenteritis), and 1.6:1 (urinary tract infection). These results strongly suggest that most nonlisted males with septicemia and multiple site infections, and a minority with gastroenteritis and urinary tract infection, were human immunodeficiency virus (HIV)-positive. Among individuals who were HIV-positive, or likely to be so, Salmonella enteritidis was more competent in causing septicemia and less competent in causing gastroenteritis than was Salmonella typhimurium; among HIV-negative individuals, the reverse was true. The different capacities for infection with and invasiveness of S. enteritidis, S. typhimurium, and other Salmonella serotypes in HIV-positive and HIV-negative individuals and the use of HIV testing for Salmonella-infected individuals are discussed.