Abstract
BackgroundHIV infection has been modifying both the epidemiology and outcome of parasite infections. Hence, this study was undertaken to determine the prevalence of Cryptosporidium and other intestinal parasite infections among HIV positives with and without Antiretroviral Treatment(ART) and its association with CD4+ T-cell count.MethodsA cross-sectional study was conducted at Fitche hospital focusing on HIV positives who came to hospital for follow-ups. A total of 378 HIV positive persons with and without ART participated in the study. Data on socio-demographic factors and diarrhoea status were obtained by interviewing all 214 with ART and 164 without ART. Stool samples were collected from all patients and examined for intestinal parasites using direct, formol-ether and modified acid-fast staining techniques.ResultsThe prevalence of intestinal parasite infections in this study was significantly higher among HIV positive persons not on ART. Specifically, the rate of infection with Cryptosporidium species, Blastocystis spp., Giardia lamblia, and Entamoeba histolytica/E. dispar were higher, particularly in those with CD4+ T-cell counts less than 200 cells/µL. Fifty seven percent of the study participants were on ART. Out of these 164/378 (43%) of the non-ART study participants were infected with at least one intestinal parasite species. Significant association was observed between lower CD4+ T-cell count (<200 cells/µL) and the prevalence of Cryptosporidium spp. and Blastocystis spp. The two parasites were significantly more prevalent in HIV positive non-ART patients.ConclusionHIV infection increased the risk of having Cryptosporidium and other intestinal parasites and diarrhoea. Therefore, raising HIV positive’s immune status and screening for intestinal parasites is important. This study showed that patients who are taking ART had a lower prevalence of diarrhoea causing parasites and Cryptosporidium suggesting that ART through improvement of immune status of the patients may have contributed to controlling diarrhoea-causing parasites in HIV positive patients.
Highlights
Intestinal parasites are endemic in many regions of the world where Human Immunodeficiency Virus/Acquired Immunodeficiency syndrome (HIV/AIDS) is prevalent
Socio-demographic and clinical information including diarrhoea and medication histories were obtained from the study participants by interview and their CD4+ T-cell counts were obtained from their medical records at the Antiretroviral Treatment (ART) centre
The majority of the study participants were urban residents (80.7%) and others were from the rural vicinities of Fitche town
Summary
Intestinal parasites are endemic in many regions of the world where Human Immunodeficiency Virus/Acquired Immunodeficiency syndrome (HIV/AIDS) is prevalent. In Sub-Saharan Africa, the prevalence of intestinal parasite infections is high and the largest burden of AIDS cases exists [1]. Even though AIDS remains a global pandemic, Ethiopia is one of the highly affected Sub-Saharan African countries. The rate of infection is remarkably high in Sub-Saharan Africa, where the majority of HIV and AIDS cases are concentrated [1]. The incidence of intestinal parasite infections reaches up to 95% in HIV positive persons in developing countries. These infections are caused both by protozoa and helminths and the main clinical manifestation of the disease caused by them is diarrhoea [4]. This study was undertaken to determine the prevalence of Cryptosporidium and other intestinal parasite infections among HIV positives with and without Antiretroviral Treatment(ART) and its association with CD4+ T-cell count
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