Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy

Bachur, Tatiana Paschoalette Rodrigues; Vale, Josias Martins; Coêlho, Ivo Castelo Branco; Queiroz, Telma; Chaves, Cristina de Souza

doi:10.1590/s1413-86702008000200004

Cited by 81 publications

(81 citation statements)

References 43 publications

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“…Since 1996, with the progressive introduction of HAART, which has helped control HIV-1 infection and reconstruct the immune system, changes have been observed in the profile of morbi-mortality among HIV-1/ AIDS patients, reflected in the reduction in opportunistic infections, including those caused by enteroparasites. A study conducted in the State of Ceará showed that with the use of HAART, the chances of being infected by enteroparasites became 5.6 times lower 14 .…”

Section: Resultsmentioning

confidence: 99%

“…However, if the association between diarrhea and AIDS occurs because of an alteration in the immunologic system, this should not occur as a result of an immune dysfunction presented by LTCD4 + cells, as shown in another study in a HIV-1-seropositive Brazilian population 9 . One of the possible collateral effects of HAART, especially of the protease inhibitors, is diarrheic manifestation 14 . However, protease inhibitor therapy and viral load may also not be related to gastrointestinal dysfunction in the population analyzed.…”

Section: Resultsmentioning

confidence: 99%

“…According to previous studies 1, 13 , I. belli has been detected with low frequency in AIDS patients; this can occur because of the liberation of immature oocysts in a noncontinuous way, which may not correspond to the asymptomatic period and may not be eliminated in the first phase of the infection, when the signs and symptoms become evident 13 . Besides, there are some difficulties in the diagnoses of I. belli as there is a fluctuation in the gastrointestinal macrobiotic or enteropathogenic agents, probably because of chemoprophylactic therapy or treatment 14 . Furthermore, the specific techniques for the diagnosis of this protozoan are not routinely performed in the laboratories in this region.…”

Section: Resultsmentioning

confidence: 99%

“…The diarrhea etiology for adults seropositive for HIV-1 in this region is not associated with HAART, but the intestinal clinical complications may be related to other enteropathogens, such as viruses, bacteria, fungi, and other emergent coccidian. In addition, the low prevalence of these enteroparasites may be linked to HAART since antiretroviral therapy can change the profile of parasite infections, probably because of the reconstitution of cell immunity and the action of these drugs on parasites 14 even in individuals with no specific therapy for enteric parasites 44 . Investigations are currently being undertaken in our laboratory to clarify the role of diverse enteropathogenic agents in noninfected HIV-1 individuals.…”

Section: Resultsmentioning

confidence: 99%

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Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

Cardoso

Galisteu

Júnior

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction:We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. Methods: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. Results: The most frequent protozoan was Isospora belli (4.2%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.8%), and Cryptosporidium parvum (0.3%). Ancylostoma duodenale (1.4%) was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4 + cell counts, viral load, and the characteristics of any particular parasite. Conclusions: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world. Keywords: Epidemiology. HIV-1. AIDS. Enteroparasites. HAART. Brazil. RESUMOIntrodução: Descrevemos a epidemiologia de enteroparasitoses em pacientes de um serviço de referência de AIDS, no noroeste paulista, Brasil. Métodos: Durante o período de janeiro de 1998 a dezembro de 2008, foi realizado este estudo retrospectivo por meio da análise dos prontuários dos pacientes diagnosticados com HIV-1/AIDS atendidos no Ambulatório de Doenças Infecto-Parasitárias do Hospital de Base, São José do Rio Preto, São Paulo. As análises estatísticas foram realizadas usando a versão 2.4.1 do software estatístico R. O nível de significância adotado foi de 5%. Resultados: O protozoário mais frequente foi o Isospora belli (4,2%), seguido da Giardia lamblia (3,5%), Entamoeba coli (2,8%) e Criptosporidium parvum (0,3%). O Ancylostoma duodenalis (1,4%) foi o helminto mais detectado, enquanto a Taenia saginata e o Strongiloides stercoralis foram observados em 0,7% das amostras. Os resultados mostraram que a diarreia foi significativamente associada com giardíase e isosporíase. Entretanto, nenhuma associação foi observada entre as contagens de células T CD4 + , carga viral e da característica de qualquer parasita em particular. Conclusões: Nossos dados podem ser úteis para futuras comparações com outras regiões do Brasil e outros países em desenvolvimento. Os dados também podem fornecer pistas importantes para a melhoria da compreensão, prevenção e controle de parasitas entéricos em todo o mundo. Palavras-chaves: Epidemiologia. HIV-1. AIDS. Enteroparasitas. HAART. Brasil.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

Cardoso

Galisteu

Júnior

et al. 2011

Rev. Soc. Bras. Med. Trop.

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“…In Brazil, the prevalence of cryptosporidiosis and cystoisosporosis among HIV-infected patients ranges from 6.4% to 9.1% and from 4.4% to 18%, respectively 1,2,6,7,11,16,18 . OLIVEIRA-SILVA et al 19 investigated the frequency of these parasites in HIV-infected patients living in the Triângulo Mineiro region and found a prevalence of 8.6% for Cryptosporidium sp.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and genetic characterization of Cryptosporidium spp. and Cystoisospora belli in HIV-infected patients

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Cabrine-Santos

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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SUMMARYCryptosporidium spp. and Cystoisospora belli are monoxenic protozoa that have been recognized as the causative agents of chronic diarrhea in immunocompromised individuals, especially HIV-infected subjects. The objective of this study was to evaluate the frequency of these intestinal protozoa in HIV-positive patients in the Triângulo Mineiro region of Brazil and to correlate the presence of these infections with clinical, epidemiological and laboratory data of the patients. Oocysts were detected in stool samples of 10 (16.9%) of the 59 patients studied, while Cryptosporidium spp. were present in 10.1% (6/59) and C. belli in 6.7% (4/59). The frequency of these parasites was higher among patients with diarrheic syndrome and CD4 + T lymphocyte counts < 200 cells/ mm 3 , demonstrating the opportunistic characteristic of these infections. A significant association was observed between the lack of adherence to antiretroviral therapy and the presence of Cryptosporidium spp. and/or C. belli. Parasitism with Cryptosporidium spp. was more frequent in February and April, the months following the period of high rainfall. The same was not observed for C. belli. Genetic characterization of two isolates led to the identification of Cryptosporidium parvum, one of the main species associated with the zoonotic transmission of cryptosporidiosis.

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Human Immunodeficiency Virus-Associated Diarrhea: Still an Issue in the Era of Antiretroviral Therapy

et al. 2015

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Over half of patients with human immunodeficiency virus (HIV) experience diarrhea that contributes negatively to quality of life and adherence to antiretroviral therapy (ART). Opportunistic infectious agents that cause diarrhea in patients with HIV span the array of protozoa, fungi, viruses, and bacteria. With global use of ART, the incidence of diarrhea because of opportunistic infections has decreased; however, the incidence of noninfectious diarrhea has increased. The etiology of noninfectious diarrhea in patients with HIV is multifactorial and includes ART-associated diarrhea and gastrointestinal damage related to HIV infection (i.e., HIV enteropathy). A basic algorithm for the diagnosis of diarrhea in patients with HIV includes physical examination, a review of medical history, assessment of HIV viral load and CD4+ T cell count, stool microbiologic assessment, and endoscopic evaluation, if needed. For patients with negative diagnostic results, the diagnosis of noninfectious diarrhea may be considered. Pharmacologic options for the treatment of noninfectious diarrhea are primarily supportive; however, the use of many unapproved agents is based on unstudied and anecdotal information. In addition, these agents can be associated with treatment-limiting adverse events (AEs), such as drug–drug interactions with ART regimens, abuse liability, and additional gastrointestinal AEs. Currently, crofelemer, an antisecretory agent, is the only therapy approved in the USA for the symptomatic relief of noninfectious diarrhea in patients with HIV on ART.

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Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy

Cited by 81 publications

References 43 publications

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

Prevalence and genetic characterization of Cryptosporidium spp. and Cystoisospora belli in HIV-infected patients

Human Immunodeficiency Virus-Associated Diarrhea: Still an Issue in the Era of Antiretroviral Therapy

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