Abstract
BackgroundThe studies on the occurrence and diversity of tick-borne infections in HIV-infected individuals have been few, and the subject has been relatively neglected when compared with other common infections associated with HIV. In HIV-positive patients in whom a serological diagnostics is complicated due to reduced positive predictive value, a method where the microorganism is detected directly is of great value. Therefore, we performed a molecular study to ascertain the prevalence and incidence of tick-borne infections in HIV-infected persons in Poland, an endemic area for Ixodes ricinus ticks.MethodsGenomic DNA was isolated from whole blood of tested patients. Detection of tick-borne pathogens was performed by amplification and sequencing of different loci. Molecular and phylogenetic analyses of obtained nucleotide sequences were performed. Serum samples were analyzed for antibodies against tick-borne pathogens by using commercial tests in all patients.ResultsAmong 148 studied blood samples from HIV-infected patients, two cases (1.4%) of infection with tick-borne pathogen were reported. No symptoms of tick-borne infection were observed in these cases. In one case a patient was infected with Anaplasma phagocytophilum – the agent of human granulocytic anaplasmosis (HGA) and in the other with Borrelia garinii.ConclusionsOur study revealed the first case of HIV positive patient infected with A. phagocytophilum. Asymptomatic tick-borne infection can occur in HIV-positive patients. The detailed history of tick bites, especially in endemic tick areas, should be considered as part of anamnesis in routine clinical care of HIV-positive patients.
Highlights
The studies on the occurrence and diversity of tick-borne infections in HIV-infected individuals have been few, and the subject has been relatively neglected when compared with other common infections associated with HIV
In patients diagnosed with Human immunodeficiency virus type 1 (HIV-1), immunodeficiency significantly increases the risk of disease caused by pathogens that expand as a consequence of reduced level of T lymphocyte (LT) CD4 + cells, and pathogenicity is usually controlled
Most cases were diagnosed as early infections, and neuroborreliosis has been confirmed in patients from the Netherlands and Sweden [11, 12]
Summary
The studies on the occurrence and diversity of tick-borne infections in HIV-infected individuals have been few, and the subject has been relatively neglected when compared with other common infections associated with HIV. In Europe, from the wide range of tick-borne pathogens, only Borrelia, Babesia and Rickettsia infections have been detected in HIV-infected humans [10,11,12,13,14]. In Europe, at least five species are considered to be pathogenic for humans (B. afzelii, B. garinii, B burgdorferi, B. spielmanii, B. bavariensis), resulting in much higher than in the United States of America variety of clinical symptoms of Lyme disease [15]. Most cases were diagnosed as early infections, and neuroborreliosis has been confirmed in patients from the Netherlands and Sweden [11, 12] Until now it remains unclear whether HIV-positive persons are at increased risk of acquiring or atypical course of tick-born infections and studies in this area are scarce. False positive serologic findings are described in patients with neurological infections with other spirochetes such as Treponema pallidum [20]
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