Candida associated diarrhea in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and their correlation with CD4+ T lymphocyte counts

Abstract

Context: Gastrointestinal opportunistic infections occur very frequently in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients and diarrhea is one of the common clinical presentations among these patients. Candida spp. have also been implicated as a causative agent of chronic diarrhea in HIV-infected patients. Aims: This study was carried out to determine the prevalence of fungal pathogen among HIV/AIDS patients presented with diarrhea and their correlation with CD4+ T lymphocyte counts. Settings and Design: This cross-sectional study was conducted in the Department of Microbiology, RIMS, Imphal. Materials and Methods: A total of 158 stool samples were examined, out of which 108 were from HIV-positive patients with diarrhea (study group) and 50 from HIV-positive patients without diarrhea (control group). Specimens were examined by direct microscopy and culture in Sabouraud's dextrose agar. The CD4+ T lymphocyte count of patient was also recorded. Statistical Analysis Used: Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version-16 software. P predictive value) value <0.05 was considered significant. Results: Confluent growth of Candida spp. was detected in stool samples of 28.7% patients with diarrhea and 12% patients without diarrhea. Association between the isolation of Candida spp. and diarrhea was found to be significant (P = 0.01). Isolation of Candida spp. was inversely correlated with CD4+ T lymphocyte count. Conclusion: Intestinal candidiasis must be held in mind as a cause of HIV/AIDS-associated diarrhea, particularly in patient with low CD4+ T lymphocyte count.