Intestinal Parasitosis and its Association with CD4+ T Cell Count and Viral Load among People Living with HIV in Parasite Endemic Settings of Northwest Ethiopia

Abstract

Purpose To study intestinal parasitosis and its association with viral load and CD4+ T cell count in HIV-infected individuals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Methods A cross-sectional study was conducted from March to June 2019. Three hundred and sixteen study participants were selected using systematic random sampling technique. Sociodemographic and clinical data were collected using structured questionnaire. Stool samples were collected and examined using direct saline, formol ether concentration technique and modified acid fast staining. CD4+ T cell counts and viral load were determined by fluorescence-activated cell sorting (BD FACS) and COBAS Ampliprep/COBAS TaqMan HI2CAP assay, respectively. Data were entered into Epi Data 3.1 and transferred to SPSS version 20 software for analysis. Bivariable and multivariable analyses were performed using a binary logistic regression model. P values of less than 0.05 were considered statistically significant. Results The overall prevalence of intestinal parasitosis was 24.7% (78/316). The most commonly detected parasite was Cryptosporidium species with 5.4% (17/316), followed by Ascaris lumbricoides with 5.1% (16/316). There was a significant association with low CD4+ T cell count (AOR: 3.207; 95% CI: 1.237, 8.317), high viral load (AOR: 2.933; 95% CI: 1.326, 6.489), individuals aged 31–40 years (AOR: 0.305; 95% CI: 0.124, 0.751) and individuals aged 41–50 years (AOR: 0.261; 95% CI: 0.101, 0.671). Conclusion In this study, prevalence of intestinal parasitic infections was high and was associated with low CD4+ T cell count and high viral load. Therefore, screening of HIV patients, especially those with low CD4+ T-cell count and high viral load, particularly for opportunistic intestinal parasitic infections would be of utmost importance in the efforts to prevent and control opportunistic infections in HIV patients.

Enteric Parasitosis of HIV-positive Patients in Cameroon: A Case of the Regional Hospital of Bafoussam (Western Region)

“…The overall prevalence of gastrointestinal parasites in the present study was 24.2%. This prevalence is close to that obtained by [17] in Cameroon 27.9%, [25] Ghana (25.2%), [26] Brazil (28.88%), [15] Ethiopia (24.7%), and [14] Colombia (29.2%). Nevertheless, it was lower than the 52.08% obtained by Taheu et al in Yaoundé, Cameroon [16].…”

“…With the improvement in the care of People Living with HIV (PLHIV) in recent years worldwide, the introduction of Highly Active Antiretroviral Therapy (HAART) as the primary treatment for HIV has led to a reduction in the frequency of infections; including those caused by enteroparasites [13]. A study in Antioquia, Colombia, in a population of people living with HIV and AIDS (PLWHA) on ART showed a prevalence of 29.2% [14] and a similar study in Ethiopia showed a prevalence of 24.7% [15]. In some regions in Cameroon a high prevalence of gastrointestinal parasites has been registered; 52.08% in Yaoundé [16], 27.9% in Douala [17], and 59.5% in Dschang (West) [18].…”

Magnitude of intestinal parasitic infections and its determinants among HIV/AIDS patients attending at antiretroviral treatment centers in East and West Gojam Zones, Northwest, Ethiopia: institution based cross-sectional study

“…Individuals with a viral load count between 20 and 1000 cps/ml were more likely to develop parasitic infections compared to those with undetectable viral load counts. This finding suggests that individuals with higher viral loads may have compromised immune systems, making them more susceptible to opportunistic infections, including intestinal parasites ( 23 , 29 ). Additionally, patients in WHO stage 4 of HIV/AIDS had a higher likelihood of being infected with parasitic infections compared to those in stage 1.…”

“…The higher rates of HIV/AIDS in urban areas due to factors such as increased mobility, higher population density, and greater access to healthcare services, and the global HIV/ AIDS epidemiology reported that young adults are often at higher risk of HIV infection due to behavioral factors, including engaging in risky sexual behaviors and substance abuse. Low educational attainment is often associated with limited health literacy, which can hinder individuals' ability to understand and adopt preventive measures against parasitic infections (18)(19)(20)(21)(22)(23).…”