Cryptosporidium Infection and Correlation with CD4+ T-cell count among Human Immunodeficiency Virus Seropositive Patients within Kaduna Metropolis, Nigeria

Abstract

Cryptosporidiosis being an opportunistic infection is becoming more prevalent in Human Immunodeficiency Virus (HIV) seropositive patients. This study was carried out to determine the prevalence of Cryptosporidium infection and the correlation with CD4+ T-cell count among HIV seropositive patients within Kaduna Metropolis, Nigeria. Stool samples were collected from 300 HIV seropositive patients between October 2011 and January 2012, and examined for oocysts and antigen of Cryptosporidium by microscopy and ELISA methods. Microscopy was used as the Gold standard and its sensitivity was compared with that of ELISA. The blood samples were also analyzed for CD4+ T-cell count by flow cytometry. Prevalence of 15% (45/300) was obtained by microscopy. Sensitivity of microscopy when compared to ELISA was found to be 24.9%. Cryptosporidium infection was associated with those who defecate in open layouts (50%: 3/6) and those who drank river water without boiling (50%: 1/2). There was a significant association between Cryptosporidium infection and diarrhoea (� 2 = 104.669, df=1, p=0.000) and also the duration of diarrhoea (� 2 = 117.073, df=4, p=0.000). The oocysts were detected more frequently in males (19.8%: 18/91) than female patients (12.9%: 27/209) and patients between age group 16-25 years were most affected (25.7%: 9/35). Cryptosporidium infection was not associated with occupation, marital status, sex, age, education, animal contact, overseas travel and swimming (p>0.05) in this study. There was a decrease in prevalence with longer duration of being on HAART. The mean CD4+ T-cell count of patients was 409.86±14.1 while the median was 382. There was a strong association between cryptosporidiosis and CD4+ T-cell count (� 2 = 58.478, df=10, p=0.000) with the highest prevalence recorded among patients with CD4+ T-cell count <200 cell/� l. This indicates that there is low opportunity for this parasite to get established as the patients CD4+ T-cell count increases and confirms the organism opportunistic nature.