Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
PLoS One. 2019 Sep 3;14(9):e0221968. doi: 10.1371/journal.pone.0221968. eCollection 2019.
Sub-Saharan Africa is endemic for intestinal parasites and distinguished for the largest burden of HIV cases. Blastocystis sp. is one of the most common protists infecting humans but its role in human disease is still controversial. Aim of this study was to investigate the prevalence of Blastocystis sp. in HIV positive and negative adults in Ghana and its association with immune status and other risk factors.
122 HIV positive outpatients and 70 HIV negative blood donors from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, were included in the present study. Demographic, clinical and laboratory data were collected and HIV positive patients distinguished for CD4+ T cell count <200 cells/μl (n = 54) and >200 cells/μl (n = 68). A Blastocystis's phylogenetic analysis was performed to determine sample subtype (ST).
The prevalence of Blastocystis sp. in adult HIV positive individuals was lower than in HIV negative persons (6.6% vs. 20.0%, p = 0.008) and Blastocystis sp. ST1 was the most prevalent strain. Within HIV positive participants, the prevalence of Blastocystis sp. was lower in those individuals with CD4+ T cell count <200 cells/μl than in patients with higher CD4+ T cell count (1.9% vs. 10.3%, p = 0.076). Multiple regression analysis revealed that Blastocystis sp. was inversely associated with an obese Body Mass Index (BMI) in HIV negative persons (p = 0.040). Presence of Blastocystis sp. was correlated with higher CD4+ T cell count in HIV positive participants (p = 0.049).
It is largely reported that people living with HIV (PLHIV) in Africa are affected from parasite infections and that co-infections may adversely impact on their immune status, accelerating progress to AIDS and worsening gastrointestinal manifestations. Differently, in this study Blastocystis sp. was associated with a better immune status jointly with a healthy body weight while it seems to be reduced with the progression of HIV infection. This data agree with recent suggestions that Blastocystis sp. can represent a component of the healthy gut microbiota.
撒哈拉以南非洲地区是肠道寄生虫的流行地区，也是 HIV 病例负担最大的地区。芽囊原虫是感染人类的最常见原生动物之一，但它在人类疾病中的作用仍存在争议。本研究旨在调查加纳 HIV 阳性和阴性成人中芽囊原虫的流行情况及其与免疫状态和其他危险因素的关系。
本研究纳入了加纳库马西科福科阿诺克耶教学医院的 122 名 HIV 阳性门诊患者和 70 名 HIV 阴性献血者。收集人口统计学、临床和实验室数据，并根据 CD4+ T 细胞计数<200 个/μl（n=54）和>200 个/μl（n=68）将 HIV 阳性患者分为两组。进行芽囊原虫的系统发育分析以确定样本亚型（ST）。
成人 HIV 阳性个体中芽囊原虫的流行率低于 HIV 阴性个体（6.6% vs. 20.0%，p=0.008），ST1 是最常见的菌株。在 HIV 阳性参与者中，CD4+ T 细胞计数<200 个/μl 的个体中芽囊原虫的流行率低于 CD4+ T 细胞计数较高的患者（1.9% vs. 10.3%，p=0.076）。多因素回归分析显示，在 HIV 阴性个体中，芽囊原虫与肥胖的体重指数（BMI）呈负相关（p=0.040）。在 HIV 阳性参与者中，芽囊原虫的存在与较高的 CD4+ T 细胞计数相关（p=0.049）。
据报道，非洲的 HIV 感染者（PLHIV）普遍受到寄生虫感染的影响，合并感染可能会对其免疫状态产生不利影响，加速向艾滋病的进展，并加重胃肠道表现。然而，在本研究中，芽囊原虫与更好的免疫状态相关，同时与健康体重相关，而随着 HIV 感染的进展，其似乎会减少。这些数据与最近的观点一致，即芽囊原虫可以作为健康肠道微生物群的一部分。
