National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite & Vector Biology Ministry of Health, Shanghai 200025, China.
Parasit Vectors. 2012 Feb 13;5:36. doi: 10.1186/1756-3305-5-36.
Intestinal parasite infections (IPIs) are among the most significant causes of illness and disease of socially and economically disadvantaged populations in developing countries, including rural areas of the People's Republic of China. With the spread of the human immunodeficiency virus (HIV) among rural Chinese populations, there is ample scope for co-infections and there have been increasing fears about their effects. However, hardly any relevant epidemiological studies have been carried out in the country. The aim of the present survey was to assess the IPI infection status among a representative sample of HIV-positive Chinese in rural Anhui province, and compare the findings with those from a cohort of non-infected individuals.
A case control study was carried out in a rural village of Fuyang, Anhui province, China. Stool samples of all participants were examined for the presence of intestinal parasites. Blood examination was performed for the HIV infection detection and anemia test. A questionnaire was administered to all study participants.
A total of 302 HIV positive and 303 HIV negative individuals provided one stool sample for examination. The overall IPI prevalence of intestinal helminth infections among HIV positives was 4.3% (13/302) while it was 5.6% (17/303) among HIV negatives, a non-significant difference. The prevalence of protozoa infections among HIV positives was 23.2% while the rate was 25.8% among HIV negatives. The species-specific prevalences among HIV positives were as follows: 3.6% for hookworm, 0.7% for Trichuris trichiura, zero for Ascaris lumbricoides, 0.3% for Clonorchis sinensis, 1.3% for Giardia intestinalis, 16.2% for Blastocystis hominis, 1.7% for Entamoeba spp. and 8.3% for Cryptosporidium spp.. Cryptosporidium spp. infections were significantly more prevalent among HIV positives (8.3%) compared to the HIV negative group (3.0%; P < 0.05). Among people infected with HIV, Cryptosporidium spp. was significantly more prevalent among males (12.6%) than females (4.4%; P < 0.05). According to multivariate logistic regression, the factors significantly associated with parasite infections of the people who were HIV positive included sex (male: OR = 6.70, 95% CI: 2.030, 22.114), younger age (less than 42 years old: OR = 4.148, 95% CI: 1.348, 12.761), and poor personal hygiene habits (OR = 0.324, 95% CI: 0.105, 0.994).
HIV positive individuals are more susceptible to co-infections with Cryptosporidium spp. than HIV negative people, particularly younger males with poor personal hygiene habits, indicating a need for targeted hygiene promotion, IPI surveillance and treatment.
肠道寄生虫感染（IPI）是发展中国家社会经济弱势群体（包括中国农村地区）患病和发病的最重要原因之一。随着艾滋病毒（HIV）在中国农村人口中的传播，合并感染的范围很大，人们越来越担心其影响。然而，中国几乎没有进行过任何相关的流行病学研究。本调查的目的是评估中国安徽省农村地区 HIV 阳性人群中 IPI 感染状况，并将结果与未感染人群的队列进行比较。
在中国安徽省阜阳市的一个农村村庄进行了病例对照研究。对所有参与者的粪便样本进行肠道寄生虫检查。对所有研究参与者进行血液检查以检测 HIV 感染和贫血情况。所有研究参与者都填写了一份问卷。
共有 302 名 HIV 阳性和 303 名 HIV 阴性个体提供了一份粪便样本进行检查。HIV 阳性个体的肠道蠕虫感染总 IPI 患病率为 4.3%（13/302），而 HIV 阴性个体的患病率为 5.6%（17/303），差异无统计学意义。HIV 阳性个体的原虫感染患病率为 23.2%，而 HIV 阴性个体的患病率为 25.8%。HIV 阳性个体的特定物种患病率如下：钩虫 3.6%，鞭虫 0.7%，蛔虫 0%，华支睾吸虫 0.3%，贾第虫 1.3%，人芽囊原虫 16.2%，肠内阿米巴 1.7%，隐孢子虫 8.3%。与 HIV 阴性组（3.0%）相比，HIV 阳性个体中隐孢子虫感染更为普遍（8.3%；P<0.05）。在感染 HIV 的人群中，男性（12.6%）比女性（4.4%）更易感染隐孢子虫（P<0.05）。根据多变量逻辑回归，与 HIV 阳性人群寄生虫感染相关的因素包括性别（男性：OR=6.70，95%CI：2.030，22.114）、年龄较小（<42 岁：OR=4.148，95%CI：1.348，12.761）和不良个人卫生习惯（OR=0.324，95%CI：0.105，0.994）。
与 HIV 阴性人群相比，HIV 阳性个体更易合并感染隐孢子虫，尤其是年龄较小、个人卫生习惯较差的男性，这表明需要有针对性地开展卫生促进、肠道寄生虫病监测和治疗工作。
