Seroprevalence of Entamoeba histolytica infection in HIV-infected individuals from Shanghai city, Anhui province, and Henan province, China, was examined by enzyme-linked immunosorbent assay using crude antigen and a recombinant surface antigen, C-Igl, of the parasite. In 215 HIV-infected individuals, the positive rates for these antigens were 12.1% and 7.9%, respectively; these rates were significantly higher than the rates of 3.1% and 0.5%, respectively, in 191 patients with gastrointestinal symptoms who were not infected with HIV. There was no significant difference in seropositivity to E. histolytica between men and women. Seropositivity in HIV-infected individuals was higher in patients with a CD4(+) T cell count of < 200/microL. This is the first report showing a higher seroprevalence of E. histolytica infection in HIV-infected patients in China. Our results also suggest that HIV infection is a risk factor for infection with E. histolytica.