Prevalence of Opportunistic Enteric Parasitic Infections in HIV Infected Individuals and their correlation with CD4 Count

Abstract

HIV infection is a worldwide phenomenon with serious public health implications. UNAIDS data 2017 stated that 36.7 million people are living with HIV infection and approximately one million death are caused due to AIDS-related illness in the year 2016. [1] Although the prevalence of HIV infection in India is less compared to other countries, currently 21.7 lakhs people carry HIV infection in India. [2] Diarrhea is a leading cause of substantial morbidity and mortality in persons infected with HIV, occurring at sometime during their illness in up to 60% of patients in industrialized nations and in up to 90% of patients in developing countries. [3] Diarrhea in these patients may occur due to various etiologies; among them, infection is been an important cause. The common organisms implicated are Cryptosporidium parvum, Isospora belli, Microsporidia species, Entamoeba histolytica, Cyclospora cayetanensis, Giardia species, Strongyloides stercoralis, Ascaris species, and Ancylostoma species. [4] Literature has shown that patients with CD4 counts <200 cells/mm 3 are 6 times more likely to develop opportunistic infections (OIs) compared to those with CD4 counts >350 cells/mm 3 . [5] There have been reports on frequency of various pathogens causing diarrhea from different parts of India. However, there appears to be a paucity of data on the correlation of CD4+ T-cell counts and the etiology of diarrhea among the HIV patients. Thus, this study was conducted to isolate and identify the opportunistic enteric parasites affecting the HIV patients and to correlate with CD4+ T-cell counts in HIV-infected patients.

Prevalence of Intestinal Parasitic Infection and Associated Factors Among HAART Initiated Children Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

“…Hence, these superimposed infections are occurring due to the extent of deterioration of the immune system and then could predict the prevalence of enteric parasites. 27,38 The current study also revealed that children who had a viral load >1,000 copies/mL were 1.8-times more likely to be infected with intestinal parasites (AOR=1.80; 95% CI=1.67-4.19; P=0.01). Despite the absence of a significant association, this is in agreement with the study conducted by Fregonesi et al, 39 which suggested that a high percentage of parasite-infected children were observed among children with high viral loads.…”

Undernutrition and associated factors among HIV-Infected adults receiving ART at Health centers, Lega Tafo and Surrounding, Ethiopia, 2021

“…HIV-infected persons are at higher risk for undernutrition, and certain conditions can magnify the risk, such as anorexia, di culty swallowing or painful swallowing, malabsorption and diarrhea, altered metabolism of nutrients, increased utilization of nutrients, and greater loss of nutrients (4). Not only this but also, there are many factors associated with HIV/AIDS undernutrition among them household food insecurity, lack of nutritional counseling, educational status, and economic status are evidenced by many studies (6,10,14,15).…”

“…In addition, adherence to ART drugs is low in undernourished HIV/AIDS patients (13).HIV-infected persons are at higher risk for undernutrition, and certain conditions can magnify the risk, such as anorexia, di culty swallowing or painful swallowing, malabsorption and diarrhea, altered metabolism of nutrients, increased utilization of nutrients, and greater loss of nutrients (4). Not only this but also, there are many factors associated with HIV/AIDS undernutrition among them household food insecurity, lack of nutritional counseling, educational status, and economic status are evidenced by many studies (6,10,14,15).Many studies were conducted on HIV/AIDS patients but since the dispute undernutrition is unanswered and still there is a lack of information in the Ethiopian context further investigation will be needed. Again, there is a difference between malnutrition and undernutrition but most of the studies use malnutrition and undernutrition interchangeably as the same term.…”

Modulation of the immune response by infection with Cryptosporidium spp. in children with allergic diseases

“…It is an opportunistic parasite with worldwide distribution and causes a self-limiting diarrhoea in immunocompetent individuals. However, in immunocompromised subjects (patients with AIDS, children with malnutrition and the elderly), the disease can be severe, prolonged and lethal (22)(23)(24). The defence mechanisms responsible for limitation of disease in humans have not been fully characterized, due to the self-limiting nature of the disease in healthy individuals and general underdiagnosis of Cryptosporidium infection.…”