Abstract
Background & objectives: Intestinal parasitic infections are major cause of diarrhoea in HIV infected individuals. The present study was undertaken to detect intestinal parasites in HIV infected patients with and without diarrhoea and to determine association between enteric parasites and CD4 T cell count. Methods: The study was carried out at Department of Microbiology, Rural Medical College, Loni, India, between September 2010 and August 2012 among consecutively enrolled 127 HIV infected patients presenting with and without diarrhoea. Stool samples were collected and examined for enteric parasites by microscopy and special staining methods. CD4 cell counts records of patients were taken from Antiretroviral Treatment Centre (ARTC) of the hospital. Results: Out of total 127 cases intestinal parasites were detected in 27 cases. The incidence of intestinal parasitic infection was 21.25%. Of 27 cases where parasites detected in total, Entamoeba histolytica 13 (48.14 %) was found to be most prevalent parasite followed by Cryptosporidium parvum 9 (33.33%) followed by Giardia lamblia 3 (11.11 %) followed by Taenia spp. 2 (7.40%). In HIV infected patients with CD4 count < 200 cells/µl, C. parvum was the most commonly observed (88.88%) parasite. Whereas the proportion of intestinal parasites in patients with CD4 count 200 – 499 cells/µl was significantly higher as compared with other two groups of patients with CD4 count < 200 and ≥ 500 cells/µl Interpretation & conclusions: Parasitic infections were detected in 21.25% HIV infected patients and low CD4 count was significantly associated with opportunistic infection. Detection of aetiologic pathogens might help clinicians to decide appropriate management strategies thereby to reduce morbidity and mortality due to intestinal parasitic infections.
Highlights
India is estimated to have the third largest HIV positive population in the world, with 2.5 million people living with HIV/AIDS and prevalence rate approximately 0.30%.1 Diarrhoea is the most common gastrointestinal infection occurs in 3060 % of AIDS patients in developed countries and in about 90 % of AIDS patients in developing countries[2,3,4,5]
In India, prevalence of intestinal parasitic infection in AIDS ranges from 20 % to 30% .Slightly higher prevalence of intestinal parasite in HIV infected patients is reported from other countries (33-50%)[18]
The maximum incidence of HIV seropositive patient and HIV associated diarrhoea was seen in the age group 31-40 in both male & female whereas the proportion of diarrhoea was higher in female as compared to male, which is similar to the results of Deorukhkar,et al.[19]
Summary
India is estimated to have the third largest HIV positive population in the world, with 2.5 million people living with HIV/AIDS and prevalence rate approximately 0.30%.1 Diarrhoea is the most common gastrointestinal infection occurs in 3060 % of AIDS patients in developed countries and in about 90 % of AIDS patients in developing countries[2,3,4,5]. In HIV infected patient, continuous impairment of immune system makes them extremely vulnerable to variety of common and opportunistic infections. Number of studies has been conducted to detect the presence of enteric parasites associated with diarrhoea in HIV/AIDS patient from India and different parts of the world. The incidence and prevalence of infection with a particular enteric parasite in HIV/AIDS patients is likely to depend upon the endemicity of that particular parasite in the community[8, 9]. A decrease in CD4+ Tlymphocyte counts is responsible for the profound immune-deficiencies that lead to various opportunistic infections in HIV-infected patients[12]. This study was conducted in rural tertiary care hospital with the aim to determine the prevalence of enteric parasites affecting the HIV patients with and without diarrhoea. An attempt was made to elucidate the association between CD4 and presence of enteric parasites
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