Jha Arun Kumar, Uppal Beena, Chadha Sanjim, Bhalla Preena, Ghosh Roumi, Aggarwal Prabhav, Dewan Richa
Department of Microbiology, Maulana Azad Medical College, University of Delhi, Bahadur Shah Zafar Marg, New Delhi 110002, India.
J Pathog. 2012;2012:971958. doi: 10.1155/2012/971958. Epub 2012 Dec 27.
Intestinal infections are a significant cause of morbidity and mortality in people living with HIV/AIDS (PLWHA) especially in developing countries. The present study was conducted to assess the clinical and microbiological spectrum in HIV/AIDS cases with diarrhea and to correlate the occurrence of such pathogens with stool characters, HIV seropositivity status, and CD4 counts. Stools from 154 HIV seropositive subjects and 50 HIV negative controls were examined by direct microscopy, fecal cultures, and serological tests (Clostridium difficile Toxin A, Cryptosporidium antigen, and Entamoeba histolytica antigen ELISA). CD4 T cell enumeration was done using FACS count (Becton Dickinson). The study showed a male preponderance (112 males and 42 females). Weakness, abdominal pain, and anorexia were the most common symptoms. Coccidian parasites were the most common cause of diarrhea in HIV seropositive cases. C. parvum was seen in 60.42% while Isospora belli in 9.03%. Amongst the bacterial pathogens C. difficile was detected in 18.06%, diarrheagenic Escherichia coli in 11.11%, and Shigella spp. in 2.78%. Pathogen isolation rates were more in HIV seropositive cases and subjects with low CD4 T lymphocyte counts. Regular monitoring of CD4 T lymphocyte counts and screening for enteric pathogens will help improve the quality of life for PLWHA.
肠道感染是艾滋病毒/艾滋病感染者发病和死亡的一个重要原因，在发展中国家尤为如此。本研究旨在评估腹泻的艾滋病毒/艾滋病病例的临床和微生物学谱，并将这些病原体的出现与粪便特征、艾滋病毒血清阳性状态和CD4细胞计数相关联。通过直接显微镜检查、粪便培养和血清学检测（艰难梭菌毒素A、隐孢子虫抗原和溶组织内阿米巴抗原酶联免疫吸附测定）对154名艾滋病毒血清阳性受试者和50名艾滋病毒阴性对照者的粪便进行检测。使用流式细胞仪计数（贝克顿·迪金森公司）进行CD4 T细胞计数。研究显示男性占多数（112名男性和42名女性）。虚弱、腹痛和厌食是最常见的症状。球虫寄生虫是艾滋病毒血清阳性病例腹泻的最常见原因。微小隐孢子虫见于60.42%的病例，贝氏等孢球虫见于9.03%的病例。在细菌病原体中，检测到艰难梭菌的占18.06%，致泻性大肠杆菌的占11.11%，志贺菌属的占2.78%。艾滋病毒血清阳性病例和CD4 T淋巴细胞计数低的受试者的病原体分离率更高。定期监测CD4 T淋巴细胞计数和筛查肠道病原体将有助于提高艾滋病毒/艾滋病感染者的生活质量。
