Parasitology Department, Medical Research Institute, Alexandria University, Egypt 165 El-Horreya Avenue, El-Hadara, Alexandria, Egypt.
Trop Biomed. 2022 Mar 1;39(1):108-116. doi: 10.47665/tb.39.1.013.
Cryptosporidium sp. cause opportunistic infections in HIV patients. Molecular differentiation provides a better understanding of the epidemiology and clinical variations of cryptosporidiosis. The present work studied the species of Cryptosporidium in HIV patients and their associated demographic and clinical features. The study included 100 adult HIV patients receiving antiretroviral therapy in Egypt. Cryptosporidium infection was diagnosed by modified Ziehl- Neelsen (MZN) stain and PCR amplification of COWP gene. The infecting species were molecularly identified by restriction fragment length polymorphism (RFLP) and DNA sequencing. Data were analyzed using Kappa ( K) agreement, Mann-Whitney U, odds ratio and the 95% confidence interval, Chi-squared and Monte Carlo significance (p) tests. The statistical significance was judged at the 5% level. A total of 16 Cryptosporidium positive cases were detected (16%), with good agreement between PCR and MZN ( K = 0.763). Among 11 PCR positive samples, RFLP identified C. hominis in five samples, C. parvum in three samples, C. meleagridis in two samples, and mixed C. hominis and C. meleagridis in one sample. Eight samples were successfully sequenced and the results confirmed the RFLP classification. C. hominis was found mainly in urban residents while C. parvum and C. meleagridis were significantly associated with rural areas ( =0.01). Diarrhoea and nausea/vomiting were recorded only in the presence of C. hominis infection while abdominal pain was the main symptom in C. parvum and C. meleagridis infections. Drinking water sources, contact with animals, and CD4 count were not related to infection with a particular species. In conclusion, infection with Cryptosporidium sp. is common and frequently symptomatic in HIV patients in Egypt. The predominant species, C. hominis, C. parvum, and C. meleagridis show a distinct distribution in urban and rural residents.
隐孢子虫属引起 HIV 患者的机会性感染。分子分化提供了对隐孢子虫病的流行病学和临床变异更好的理解。本工作研究了埃及接受抗逆转录病毒治疗的 100 例成年 HIV 患者中的隐孢子虫属物种及其相关的人口统计学和临床特征。隐孢子虫感染通过改良的齐尔-尼尔森（MZN）染色和 COWP 基因的 PCR 扩增来诊断。通过限制性片段长度多态性（RFLP）和 DNA 测序对感染物种进行分子鉴定。使用 Kappa（ K）一致性、Mann-Whitney U、比值比和 95%置信区间、卡方和蒙特卡罗显著性（p）检验分析数据。在 5%的水平上判断统计显著性。共检测到 16 例隐孢子虫阳性病例（16%），PCR 和 MZN 之间具有良好的一致性（ K=0.763）。在 11 个 PCR 阳性样本中，RFLP 鉴定出 5 个样本为 C. hominis、3 个样本为 C. parvum、2 个样本为 C. meleagridis，1 个样本为 C. hominis 和 C. meleagridis 混合感染。8 个样本成功测序，结果证实了 RFLP 分类。C. hominis 主要在城市居民中发现，而 C. parvum 和 C. meleagridis 与农村地区显著相关（ =0.01）。仅在存在 C. hominis 感染时才记录腹泻和恶心/呕吐，而腹痛是 C. parvum 和 C. meleagridis 感染的主要症状。饮用水源、与动物接触和 CD4 计数与特定物种的感染无关。总之，埃及 HIV 患者中隐孢子虫属感染很常见且常伴有症状。优势种 C. hominis、C. parvum 和 C. meleagridis 在城市和农村居民中分布明显不同。
