Molecular Characterization of Cryptosporidium spp. in HIV-infected Persons in Benin City, Edo State, Nigeria

Abstract

The use of molecular tools in epidemiological investigations has provided new insights into the transmission of cryptosporidiosis in humans and animals. This study aimed to characterize the transmission of cryptosporidiosis in human immunodeficiency virus (HIV)-infected patients. Stool specimens were collected from 500 HIV-infected patients as part of the routine patient care. Cryptosporidium species in stool specimens were detected and differentiated using a small subunit rRNA-based polymerase chain reaction-restriction fragment length polymorphism technique. C. hominis and C. parvum were found and subtyped by DNA sequence analysis of the 60 kDa glycoprotein (gp60) gene. Cryptosporidium species were detected in 36 HIV patients and none were found among non-HIV patients. A CD4+ count < 200 cells/μL was a significant risk factor for acquiring cryptosporidiosis (odds ratio = 21.214; 95% confidence interval = 9.917, 45.381; p < 0.0001). Cryptosporidium infection was also associated with weight loss and diarrhea. Other risk factors included animal contact, and using stream/river or well water as drinking water. Genotyping of the Cryptosporidium species identified the presence of C. hominis (47.2%), C. parvum (44.4%), C. felis (5.6%) and C. canis (2.8%). The C. hominis specimens subtyped belonged to the Ia, Ib and Ie subtype families, whereas those of C. parvum belonged to the IIc and two new subtype families. Anthroponotic transmission appears to be important in cryptosporidiosis epidemiology in HIV-infected persons in Nigeria despite the high frequency of C. parvum infection and the identification of animal contact as a risk factor.