Epidemiology of infections with intestinal parasites and human immunodeficiency virus (HIV) among sugar-estate residents in Ethiopia.

Abstract

Intestinal parasitic infections could play an important role in the progression of infection with human immunodeficiency virus (HIV), by further disturbing the immune system whilst it is already engaged in the fight against HIV. HIV and intestinal parasitic infections were investigated in 1239, randomly selected individuals, aged 15-54 years, living on a sugar estate in central Ethiopia. Intestinal parasites were identified in faecal samples (one/subject) using direct, concentration, and (for Strongyloides stercoralis larvae) Baermann methods. HIV serological status was determined using ELISA, with ELISA-positive samples confirmed as positive by western blotting. Most (70.1%) of the subjects were infected with at least one intestinal parasite and 3.1% were seropositive (but asymptomatic) for HIV. The intestinal parasites identified in the study population were amoebic parasites (Entamoeba histolytica/Enta. dispar) (24.6%), hookworms (23.8%), Ascaris lumbricoides (22.2%), Trichuris trichiura (19.5%), S. stercoralis (13.0%), Taenia saginata (4.5%), Giardia lamblia (3.0%), and Enterobius vermicularis (1.3%). Overall, the HIV-positives were no more or less likely to carry intestinal parasites than the HIV-negatives (76.2% v. 69.9%; P > 0.05). However, when each parasite was considered separately, amoebic parasites were found to be more common in the HIV-positives than the HIV-negatives (43.7% v. 24.0%; P < 0.05). This difference remained significant in a multivariate analysis, after controlling for the socio-demographic characteristics of the study participants. In conclusion, there was moderate interaction between intestinal parasites and HIV at the asymptomatic stage of HIV infection. The observed association between amoebic and HIV infections requires confirmation in a prospective study, allowing for the analysis of biological mechanisms involved in the association.