Diarrhea, CD4 counts and enteric infections in a hospital – based cohort of HIV-infected patients around Varanasi, India

Attili, Suresh; Gulati, Anil Kumar; Singh, Vakil; Varma, Deepak; Rai, Madhukar; Sundar, Shyam

doi:10.1186/1471-2334-6-39

Cited by 49 publications

(57 citation statements)

References 14 publications

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“…In this study it was observed that most of the diarrhoea cases were due to pathogens, which correlates with results found elsewhere [19,20]. Therefore, apart from the effects of HIV enteropathy, the presence of intestinal parasites is an important contributing factor to diarrhoea, which in the longer term could result in the wasting syndrome called "slim disease" [3,21].…”

Section: Discussionsupporting

confidence: 71%

Intestinal parasitic and candida infection associated with HIV infection in Cameroon

Lehman

Kangam

Mbenoun

et al. 2013

J Infect Dev Ctries

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Introduction: HIV causes progressive impairment of the cellular immune system leading to increased susceptibility to infectious agents. Parasitic infestations are common in HIV-infected patients and usually lead to diarrhoea. Few studies have addressed the issue of intestinal parasites among HIV-infected persons in Cameroon. This investigation was conducted in Douala, Cameroon, to assess the prevalence of gastrointestinal parasites in HIV-infected patients, taking into account their immune status and treatment course. Methodology: Stool and blood samples were collected from 201 HIV-positive patients for the investigation of intestinal pathogens and CD4

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Section: Discussionsupporting

confidence: 71%

Intestinal parasitic and candida infection associated with HIV infection in Cameroon

Lehman

Kangam

Mbenoun

et al. 2013

J Infect Dev Ctries

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“…Factors associated with intestinal parasitic infections (multiple-regression analysis) participants with lower CD4 T-cell counts. Higher prevalence of diarrhoea in association with lower CD4 T-cell counts has been reported by several studies [10,[19][20][21][22]. A recent study from Denmark has also reported diarrhoea as a common symptom in HIVinfected individuals; however, it emphasized that the diarrhoea is not associated with lower CD4 T-cell count or the presence of intestinal parasites [23].…”

Section: Discussionmentioning

confidence: 83%

Intestinal parasitic infection among the HIV-infected patients in Nepal

Tiwari

Ghimire

Malla

et al. 2013

J Infect Dev Ctries

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Introduction: Intestinal parasitic infection has been a significant problem in HIV patients, worldwide. In this study, we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in people infected with HIV and attending National Public Health Laboratory in Kathmandu, Nepal, for CD4 T-cell count. Methodology: An analytical cross-sectional study in 745 HIV-infected people attending for CD4 T-cell count was conducted. Results: The prevalence of intestinal parasitic infection was 22.4% (95% CI 19.5 to 25.5). In univariate analysis, age, sex, longer time since diagnosis of HIV, CD4 T-cell count of <200/µL, diarrhoea, marital status, and being under tuberculosis (TB) treatment were significantly associated with increased odds of intestinal parasite infection. However, in the logistic regression model, only the CD4 T-cell count of <200/µL (adjusted OR=4.2, 95% CI 2.5 to 7.0), diarrhoea (adjusted OR=2.8, 95% CI 1.8 to 4.3) and being under TB treatment (adjusted OR=2.9, 95% CI 1.8 to 4.6) remained as significant predictors. On stratification, CD4 T-cell count of <200/ µL was independently associated with higher odds of protozoal as well as helminthes infection. The parasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/µL. Conclusions: Both protozoal and helminthic intestinal parasitic infections are common in HIV-infected people seeking care in healthcare facilities. The poor immune status as indicated by low CD4 T-cell count and TB may account for such a high risk of parasitic infection.

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“…However, it has been reported that the diagnostic yield of the stool analysis is low in patients with higher CD 4 + counts. It has also been suggested that HAART helps in eradicating opportunistic protozoal infections and that it is associated with the influx of CD 4 + cells into the lamina propria [24].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Intestinal Parasitic Infestation and the Related Profile of the CD4+ Counts in HIV/AIDS People with Diarrhoea in Jaipur City

Vyas

Sood²,

Sharma³

et al. 2013

JCDR

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Introduction: Gastrointestinal Tract (GIT) infections are among the most frequent infections in HIV/AIDS patients. The intestinal opportunistic parasitic infections in HIV-infected subjects present most commonly as diarrhoea. A study was conducted to determine the prevalence of enteric parasitic infections in HIV infected patients with diarrhoea, with different levels of immunity. Methods:This study was carried out at the HIV Lab of the Microbiology Department of a tertiary care teaching hospital in Jaipur, Rajasthan, between June-October 2009 among consecutively enrolled 75 HIV infected patients who presented with diarrhoea. Stool samples were collected and examined for enteric parasites by using microscopy and special staining methods. The CD 4 + cell counts were estimated by using the FACS count system. Results:Intestinal parasitic pathogens were detected in 38.66% patients, Cryptosporidium species was the most common enteric opportunistic parasite which accounted for 37.93 % of the total parasites, followed by Isospora belli 31.03 %. In the HIV infected patients with CD 4 + counts of < 200 cells/µl, parasites were identified in 56.25 % patients and in HIV patients with CD 4 + counts between 200-499 cells /µl, parasites could be identified in 27.5 % of the patients . No parasite was detected in the patients with CD 4 + counts of >500 cells/ µl. Conclusion:Parasitic infections were detected in 38.66% HIV infected patients with diarrhoea and a low CD 4 + count was significantly associated with opportunistic infections. Identification of the aetiological agent of diarrhoea in an HIV patient is very important, as it can help in the institution of the appropriate therapy and the reduction of the morbidity and the mortality in these patients.

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Diarrhea, CD4 counts and enteric infections in a hospital – based cohort of HIV-infected patients around Varanasi, India

Cited by 49 publications

References 14 publications

Intestinal parasitic and candida infection associated with HIV infection in Cameroon

Intestinal parasitic and candida infection associated with HIV infection in Cameroon

Intestinal parasitic infection among the HIV-infected patients in Nepal

The Prevalence of Intestinal Parasitic Infestation and the Related Profile of the CD4+ Counts in HIV/AIDS People with Diarrhoea in Jaipur City

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