Prevalence of opportunistic intestinal parasitic infections among HIV-infected patients with low CD4 cells counts in France in the combination antiretroviral therapy era

Pavie, Juliette; Menotti, Jean; Porcher, Raphaël; Donay, Jean Luc; Gallien, Sébastien; Sarfati, Claudine; Derouin, Francis; Molina, Jean‐Michel

doi:10.1016/j.ijid.2012.05.1022

Cited by 39 publications

(24 citation statements)

References 20 publications

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“…The increased frequency of OIs with decreasing CD4 counts observed in our study indicates the predictive value of CD4 count for the development of AIDS and its important implication for acquiring OIs that usually complicates AIDS, as previously documented [17,18].…”

Section: Discussionsupporting

confidence: 84%

Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

Saeed

Farid

Jamsheer

2015

J Infect Dev Ctries

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Introduction: This study aimed to examine the prevalence of opportunistic infections in HIV-infected patients in Bahrain and its relation to absolute CD4 count, CD4%, and CD4/CD8 ratio. Methodology: This retrospective cohort study used laboratory records (January 2009 -May 2013) from a major hospital in Bahrain. Opportunistic infections (OIs); absolute CD4 counts, CD4%, and CD4/CD8 ratio were recorded. Results: CD4% and absolute CD4 count in HIV patients with associated infections (157 ± 295) was significantly lower than in those without associated infections (471 ± 285) (p < 0.001). There was no significant difference in CD4/CD8 ratio between the two groups. Infection with Staphylococcus aureus was the commonest infection, present in 9.8% of total HIV-infected patients and 28.7% of members of the AIDS patient group with OIs, followed by yeast infections (9.2% and 27.2%, respectively). Mycobacterium tuberculosis was present in 3.6% of total HIV-infected patients and 10.6% of the group with OIs, while mycobacteria other than tuberculosis (MOTT) was present in 2.5% and 7.5%, respectively. Pneumocystis jirovecii pneumonia (PCP) was observed in 5.1% and 15.1%, respectively. Herpes simplex II (HSV-II) was observed in 3% and 9%, respectively, while Cytomegalovirus antigenemia was only present in 2% and 6%, respectively. Streptococcus pneumoniae, Streptococcus milleri, Stenotrophomonas maltophilia, and Citrobacter species were bacterial infections observed least frequently. Conclusions: Studying the pattern of OIs in HIV-infected patients in Bahrain is of paramount importance due to the scarcity of data in the Arab world. This will help to improve physicians' awareness to improve care of HIV-infected patients.

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Section: Discussionsupporting

confidence: 84%

Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

Saeed

Farid

Jamsheer

2015

J Infect Dev Ctries

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“…The overall prevalence (35.9%) of intestinal parasites among PLWHA receiving HAART remains significant. This finding was relatively higher than previous studies conducted in France (22%), Brazil (14%), Nepal (22.4%), Congo (8.5%), Cameron (24.6%), and Nigeria (15.3%) [32–37]. However, the result of this study was lower than a study conducted in Iran (67.7%) and in different countries of Ethiopia including in selected ART clinic Adama, Afar, Dire-Dawa (48%), and Bahirdar (69%) [22, 38, 39].…”

Section: Discussioncontrasting

confidence: 68%

Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia

Gedle

Kumera

Eshete

et al. 2017

J Health Popul Nutr

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BackgroundIntestinal parasitic infections and HIV/AIDS have been the major public health problems and remain a vital cause of morbidity and mortality in developing countries. Both problems are linked in a vicious cycle. The magnitude of intestinal parasites was prevalent among people living with HIV/AIDS even in the HAART era. However, the pertinent risk factors associated with intestinal parasites among HIV/AIDS patients were not well investigated in Ethiopia particularly at Butajira town. Therefore, the aim of this study was to determine the prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients on HAART in Butajira, Ethiopia.MethodA cross-sectional study was conducted, and a total of 323 study subjects was involved in the study. A systematic random sampling technique was used to select each participant during data collection. Stool specimen was collected and processed using direct wet mount, formol-ether concentration technique, and modified Ziehl-Neelson staining techniques to identify both common and opportunistic intestinal parasites. Structured questionnaire was used to collect socio-demographic, environmental, clinical, and nutritional data. Both bivariate and multivariate logistic regression analyses were used to assess the association of various explanatory factors on intestinal parasites. P value ≤0.05 at 95% CI was considered statistically significant.ResultsThe overall prevalence of intestinal parasites was 35.9% (95% CI 31.0–40.9%). Protozoa’s (Entanmoeba histolytica/dispar trophozoite, E. histolytica/dispar cyst, Giardia lamblia trophozoite, and G. lamblia cyst), helminths (Tanea species, Ascaris lumbricoides, Strongyloid stercoralis, Hookworm species and H. nana), and opportunistic intestinal parasites (Cryptosporidium parvum, Isospora belli) were observed in 57 (17.1%), 46 (14.4%), and 28 (8.7%) study participants respectively. Multivariate logistic regression analysis revealed that the presence of animals (AOR 6. 14; 95% CI 3.13, 12.0); using river water (AOR 4.87; 95% CI 1.14, 20.7); undernutrition (AOR 2.59; 95% CI 1.36–4.95); and level of immunosuppression (AOR 4.02; 95% CI 1.78–9.05 and AOR 2.84; 95% CI 1.37–5.89) were significantly associated with intestinal parasites.ConclusionsThe prevalence of intestinal parasites found to be higher among HIV/AIDS patients receiving HAART at Butajira Hospital, southern Ethiopia. Presence of animals, using river water, lower CD4 T cell count, and undernutrition were significant factors affecting intestinal parasites. Therefore, consistent detection of intestinal parasites and deworming of patients should be performed as well as improving health education on personal hygiene, avoiding contact with pit or domestic animals, and using safe or treated water. Furthermore, improving nutritional support and household food access are recommended.

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“…Likewise, it seems necessary to study this distinct action of T subsets against Encephalitozoon depending on the presence of absence of the disease since the prevalence of opportunistic intestinal parasitic infections including microsporidia is higher in patients with low CD4 cell counts [28].…”

Section: Discussionmentioning

confidence: 99%

Microsporidia and Its Relation to Crohn's Disease. A Retrospective Study

et al. 2013

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BackgroundThe cause of Crohn's Disease (CD) remains unknown. Recently a decrease in the global lymphocyte population in the peripheral blood of CD patients has been reported. This decrease was more evident in γδ T lymphocytes, especially γδ CD8+T subsets. Furthermore, a decrease of IL-7 was also observed in these patients. We propose the hypothesis that microsporidia, an obligate intracellular opportunistic parasite recently related to fungi, in CD patients can take advantage of the lymphocytes and IL-7 deficits to proliferate and to contribute to the pathophysiology of this disease.Methods and FindingsIn this case-control study, serum samples were collected from 36 CD patients and from 36 healthy individuals (controls), IgE and IgG anti-Encephalitozoon antibodies were determined by ELISA; and forty-four intestinal tissue samples were analyzed through real time Polymerase Chain Reaction (PCR), twenty CD patients, nine with others diseases and 15 healthy subjects.We observed that IgE anti-Encephalitozoon levels were significantly higher in patients with CD: 0.386(±0.256) vs control group, 0.201(±0.147), P<0.001. However, IgG anti-Encephalitozoon values were significantly lower in CD patients: 0.361(±0.256) vs control group, 0.876(±0.380), P<0.001. In the group of CD patients, 6/20 (30%) were positive by real time PCR for microsporidia and, all the patients of the control group were negative by real time PCR.ConclusionsThese results suggest that CD patients are a group at risk for microsporidiasis and, moreover that microsporidia may be involved as a possible etiologic factor of CD.

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Prevalence of opportunistic intestinal parasitic infections among HIV-infected patients with low CD4 cells counts in France in the combination antiretroviral therapy era

Abstract: The prevalence of intestinal parasitic infections remains significant in HIV-infected patients with low CD4 counts in the cART era. A systematic search for parasitic pathogens including microsporidia, cryptosporidia, and G. duodenalis should be performed even in the absence of diarrhea.

Cited by 39 publications

References 20 publications

Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia

Microsporidia and Its Relation to Crohn's Disease. A Retrospective Study

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