Abstract
BackgroundBlastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health. Studies on the prevalence of Blastocystis in HIV-positive patients are limited and dated.MethodsA cross-sectional study was carried out involving 156 HIV-positive patients to evaluate the prevalence of Blastocystis-subtypes by molecular amplification and sequencing the small subunit rRNA gene (SSU rDNA), to identify the risk factors for its transmission, to examine the relationship between the presence of the protist and gastrointestinal disorders. Furthermore, the evaluation of the faecal calprotectin by immunoassay from a sample of subjects was performed to evaluate the gut inflammation in Blastocystis-carriers.ResultsBlastocystis-subtypes ST1, ST2, ST3, ST4 were identified in 39 HIV-positive patients (25%). No correlation was found between the presence of the protist and virological or epidemiological risk factors. Blastocystis was more frequently detected in homosexual subjects (p = 0.037) infected by other enteric protozoa (p = 0.0001) and with flatulence (p = 0.024). No significant differences in calprotectin level was found between Blastocystis-carriers and free ones.ConclusionsBlastocystis is quite common in HIV-positive patients on ART showing in examined patients 25% prevalence. Homosexual behaviour may represent a risk factor for its transmission, while CD4 count and viremia didn’t correlate with the presence of the protist. The pathogenetic role of Blastocystis remains unclear and no gut inflammation status was detected in Blastocystis-carriers. The only symptom associated with Blastocystis was the flatulence, evidencing a link between the presence of the protist and the composition and stability of gut microbiota.
Highlights
Blastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health
Despite several studies reported Blastocystis implicated in different intestinal diseases, potential pathogenetic factors have been described and its presence is frequently associated with symptoms in humans [12], its pathogenetic role is so far under debated and several variables, as well as the Blastocystis subtype and load, host’s immune status and dysbiosis, could affect the occurrence of the disease [13, 14]
This study aimed to evaluate the prevalence of Blastocystis subtypes in Human Immunodeficiency Virus (HIV)-positive patients, to evaluate the potential the risk factors for its transmission and the relationship between the presence of the protozoon and gastrointestinal symptoms and, to assess the level of fecal calprotectin (FC) in Blastocystis-colonized subjects
Summary
Blastocystis is one of the most common intestinal protozoa in human faecal samples with uncertain impact on public health. Blastocystis spp. is a common intestinal protist distributed worldwide infecting humans and animals, with a prevalence from 0.5–30% and 30–76% in industrialized and developing countries, respectively [1]. This difference can be explained by poor hygiene practices and consumption of contaminated food or water [2,3,4,5] since. Despite several studies reported Blastocystis implicated in different intestinal diseases, potential pathogenetic factors have been described and its presence is frequently associated with symptoms in humans [12], its pathogenetic role is so far under debated and several variables, as well as the Blastocystis subtype and load, host’s immune status and dysbiosis, could affect the occurrence of the disease [13, 14]. A positive correlation between high bacterial richness and the presence of Blastocystis has been reported [17]
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