Assefa Shimelis, Erko Berhanu, Medhin Girmay, Assefa Zelalem, Shimelis Techalew
Department of Medical Laboratory Science, Gondar University, PO Box 196 Gondar, Ethiopia.
BMC Infect Dis. 2009 Sep 18;9:155. doi: 10.1186/1471-2334-9-155.
HIV infection has been modifying both the epidemiology and outcome of parasitic infections. Hence, this study was undertaken to determine the prevalence of intestinal parasitic infection among people with and without HIV infection and its association with diarrhea and CD4 T-cell count.
A cross-sectional study was conducted at Hawassa Teaching and Referral Hospital focusing on HIV positive individuals, who gave blood for CD4 T-cell count at their first enrollment and clients tested HIV negative from November, 2008 to March, 2009. Data on socio-demographic factors and diarrhea status were obtained by interviewing 378 consecutive participants (214 HIV positive and 164 HIV negative). Stool samples were collected from all study subjects and examined for parasites using direct, formol-ether and modified acid fast stain techniques.
The prevalence of any intestinal parasitic infection was significantly higher among HIV positive participants. Specifically, rate of infection with Cryptosporidium, I. belli, and S. stercoralis were higher, particularly in those with CD4 count less than 200 cells/microL. Diarrhea was more frequent also at the same lower CD4 T-cell counts.
Immunodeficiency increased the risk of having opportunistic parasites and diarrhea. Therefore; raising patient immune status and screening at least for those treatable parasites is important.
HIV感染一直在改变寄生虫感染的流行病学特征和结局。因此,开展本研究以确定HIV感染者和未感染者肠道寄生虫感染的患病率及其与腹泻和CD4 T细胞计数的关联。
在哈瓦萨教学与转诊医院进行了一项横断面研究,研究对象为2008年11月至2009年3月期间首次登记进行CD4 T细胞计数的HIV阳性个体以及HIV检测阴性的患者。通过对378名连续参与者(214名HIV阳性和164名HIV阴性)进行访谈,获取社会人口学因素和腹泻状况的数据。从所有研究对象中采集粪便样本,采用直接涂片法、甲醛乙醚法和改良抗酸染色技术检测寄生虫。
HIV阳性参与者中任何肠道寄生虫感染的患病率显著更高。具体而言,隐孢子虫、贝氏等孢球虫和粪类圆线虫的感染率更高,尤其是CD4细胞计数低于200个/微升的患者。在相同的低CD4 T细胞计数水平下,腹泻也更频繁。
免疫缺陷增加了机会性寄生虫感染和腹泻的风险。因此,提高患者免疫状态并至少对那些可治疗的寄生虫进行筛查很重要。