Abstract
Introduction: Studies in India indicated that diarrhoea has been the third common clinical presentation in AIDS patients. It is a second leading cause of hospital visit in developing nations and makes its place top ten worldwide. A diagnostic spectrum of enteric pathogen causing diarrhoea includes bacteria, parasites, fungi & viruses. Some pathogen tend to occur more frequently to cause more severe disease in person infected with HIV than in HIV uninfected persons with diarrhoea. These include Salmonella spp., Isospora spp., Crytptosporidium spp., Microsporidia spp., Cytomegalovirus. Aims & Objectives: Present study was undertaken to find out which etiological agents are most commonly responsible for causing diarrhoea in HIV seropositive patients. Material Methods: Total 181 cases were included in study out which 150 were HIV seropositive and 31 were HIV seronegative. Diagnosis of HIV infection was done as per NACO guidelines and CD4 count estimation was done. Isolation of bacterial pathogen was done using standard bacteriological procedures and parasite detection was done by direct examination after formal ether concentration technique, using staining as: modified Kinyouns acid fast staining and modified acid fast trichrome staining. Results: In this study, most common bacterial pathogen detected was Escherichia coli ( 57.6%), followed by Proteus spp (9.4%), % klebsiella spp ( 7.7%). Most common protozoal parasite was Cryptosporidium (53.6%), & Microsporidium (2.9%) and most common helminthic parasite was S. stercoralis (1.6%). All the enteric pathogens were predominantly detected with CD4+ count < 200 cells/ul. Conclusion: Cryptosporidium was the most common 53.6% parasitic enteropathogen detected while diarrheogenic E. coli 18.2% was the most common bacterial enteropathogens isolated. Majority of cases were with <200 CD4+ count had more than one pathogen.
Highlights
Studies in India indicated that diarrhoea has been the third common clinical presentation in AIDS patients
Intestinal pathogens and the etiological agents vary from patient to patient depending upon the immune status of the patients and from country to country depending on the geographical distribution, endemicity, seasonal variation of the enteric pathogens.[1,2,3,4]
Diarrhoea has been associated with 50% of HIV/AIDS patients in the developed world and in up to 100% of patients residing in developing countries.[11,12,13]
Summary
Opportunistic enteric infections are major source of diarrhoeal disease in developing countries mainly in HIV infected patients. Gastrointestinal infections are very common in patients with HIV infection or patients with AIDS.[6] Diarrhoea is a common clinical presentation of these infections. Diarrhoea may significantly diminish patient’s quality of life and if it persists may cause dehydration, poor nutrition, and weight loss.[9,10] Diarrhoea has been associated with 50% of HIV/AIDS patients in the developed world and in up to 100% of patients residing in developing countries.[11,12,13]. Diagnosis and management of accompanying infections are critical for improving the health and wellbeing of people infected with HIV.[5]
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