Fumagillin for Intestinal Microsporidiosis

To the Editor: Molina et al. (June 20 issue)¹ report a two-week study confirming the activity of fumagillin against intestinal microsporidiosis in 12 immunosuppressed adults, 10 of them with advanced human immunodeficiency virus (HIV) infection. Ten patients had partial clinical responses after a median of 10 months; histologic improvement was not documented. It is not certain, however, that these prolonged responses were a result of fumagillin therapy. As the authors note, highly active antiretroviral therapy for HIV infection is also effective against intestinal microsporidiosis (and cryptosporidiosis), probably because it improves immune function.^2,3 Of five of our patients who had . . .