HIV Diarrhea Research Articles

Pragmatic Combination of Available Diagnostic Tools for Optimal Detection of Intestinal Microsporidia.

Diarrhea is a debilitating condition in HIV infected individuals and with the finding that almost 1/4 cases of diarrhea in HIV are due to microsporidia, there is a dire need to institute measures for its detection on a regular basis. Keeping this in mind the study aims to determine the burden of intestinal microsporidiosis in HIV seropositive patients presenting with and without diarrhea and to compare the ability of microscopy and PCR in its detection.The study group consisted of 120 patients divided into four groups HIV seropositive with/without diarrhea, and HIV seronegative with/without diarrhea. Performance of four staining techniques including Modified Trichrome, Calcofluor White, Gram Chromotrope and Quick hot Gram Chromotrope stains were evaluated against PCR in diagnosing enteric microsporidiosis from stool samples.Overall prevalence of intestinal microsporidiosis was 10.83%. The same for HIV seropositive patients with diarrhea was 23.33%, HIV seropositive patients without diarrhea and in immune-competent hosts with diarrhea was 10% each. Enterocytozoon bieneusi was found to predominate. Calcofluor white stain detected maximum microsporidia in stool samples (76.92%), followed by Modified Trichrome stain (61.5%), PCR (46.15%) and Gram Chromotrope and Quick hot Gram Chromotrope stains (38.4% each). PCR exhibited the best performance with a sensitivity and specificity of 100%. Our data suggests screening of stool samples with either Modified Trichrome or Calcofluor white stain followed by PCR confirmation thus leading to maximum detection along with speciation for complete cure.

Frequency of Microsporidial Infection in Immunocompromised Patients with Staining and Molecular Methods Based on Internal Transcribed Spacer Region Gene in Two Cities of Southwest Iran during 2013-2014

Microsporidiosisis anopportunistic infection frequently diagnosed in immunocompromised patients. Microsporidiosis causes symptomatic or asymptomatic infections immunocompromised/immunosuppressed patients may experience severe and disseminated microsporidiosis. Fecal samples were taken from 186 patients with human immunodeficiency virus (86) and cancer (100). Microsporidia spp. were detected 27.9% (24/86) and 11.6% (10/86) in HIV + patients, 18% (18/100) and 7% (7/100) of cancer patients using polymerase chain reaction (PCR) and trichrome staining respectively. <em>Enterocytozoon bieneusi</em> was detected in 28(66.7%) patients, while <em>Encephalitozoon intestinalis</em> was detected in 10 (23.8%) patients. <em>Encephalitozoon cuniculi</em> was detected in only one patient, while<em> Encephalitozoon helle</em>m was detected in three patients. Microsporidia was significantly higher in patients with diarrhea than those without diarrhea (P = 0.001). CD4 T cells blood count was significantly lower (<200 cells/μl blood) in HIV+ patients with Microsporidia (P = 0.001). Also, there was significant difference between contact with animals with positive results of HIV+ and cancer patients (P< 0.005). This study confirmed that PCR technique was more sensitive than trichrome staining for diagnosis. Moreover, intestinal microsporidiosis caused diarrhea in HIV+ and cancer patients. This influenced treatment. Therefore, early diagnosis of microsporidiosis is effective on treatment strategies.

Frequency of Microsporidial Infection in Immunocompromised Patients with Staining and Molecular Methods Based on Internal Transcribed Spacer Region Gene in Two Cities of Southwest Iran during 2013-2014

Microsporidiosisis anopportunistic infection frequently diagnosed in immunocompromised patients. Microsporidiosis causes symptomatic or asymptomatic infections immunocompromised/immunosuppressed patients may experience severe and disseminated microsporidiosis. Fecal samples were taken from 186 patients with human immunodeficiency virus (86) and cancer (100). Microsporidia spp. were detected 27.9% (24/86) and 11.6% (10/86) in HIV + patients, 18% (18/100) and 7% (7/100) of cancer patients using polymerase chain reaction (PCR) and trichrome staining respectively. <em>Enterocytozoon bieneusi</em> was detected in 28(66.7%) patients, while <em>Encephalitozoon intestinalis</em> was detected in 10 (23.8%) patients. <em>Encephalitozoon cuniculi</em> was detected in only one patient, while<em> Encephalitozoon helle</em>m was detected in three patients. Microsporidia was significantly higher in patients with diarrhea than those without diarrhea (P = 0.001). CD4 T cells blood count was significantly lower (<200 cells/μl blood) in HIV+ patients with Microsporidia (P = 0.001). Also, there was significant difference between contact with animals with positive results of HIV+ and cancer patients (P< 0.005). This study confirmed that PCR technique was more sensitive than trichrome staining for diagnosis. Moreover, intestinal microsporidiosis caused diarrhea in HIV+ and cancer patients. This influenced treatment. Therefore, early diagnosis of microsporidiosis is effective on treatment strategies.

Opportunistic agents causing diarrhea in HIV

Opportunistic agents causing diarrhea in HIV

Cryptosporidiosis in HIV seropositive patients in Kasturba Hospital, Manipal, Karnataka, South India

Background: Cryptosporidium parvum a coccidian protozoal parasite causes a protracted life threatening diarrhea in HIV sero-positive patients. This study was conducted to find out distribution of cryptosporidium infection in HIV sero-positive patients (with acute or chronic diarrhea) admitted in Kasturba Hospital, Manipal, South India. Method: Freshly passed stool samples were collected and stained with modified Ziehl Neelson staining technique and examined under microscope for the detection of oocyst of Cryptosporidium. Results: Thirty out of 70 (42.85%) of HIV sero-positive patients were found to have Cryptosporidium parvum oocyst in their stool samples . Conclusion: Known prevalence of cryptosporidial in HIV positive patients can help in starting prophylaxis and can significantly reduce morbidity and mortality associated with severe diarrhea. Journal of Institute of Medicine Vol.27(2) 2005

The mechanism of diarrhea in HIV is based on an impaired epithelial barrier function that could be induced by a specific cytokine pattern.

The mechanism of diarrhea in HIV is based on an impaired epithelial barrier function that could be induced by a specific cytokine pattern.