The estimated prevalence rate of adults living with HIV infection in MENA is one of the lowest in the world. To date, no data on the genetic characteristics of Cryptosporidium isolates from HIV/AIDS patients in Algeria were available. This study aimed to identify Cryptosporidium species and subtype families prevalent in Algerian HIV-infected patients and contribute to the molecular epidemiology mapping of Cryptosporidium in the MENA region. A total of 350 faecal specimens from HIV/AIDS patients were analysed using microscopy, and a Cryptosporidium infection was identified from 33 samples, with 22 isolates successfully sequencing and confirming species and subtypes. Based on sequence analysis, 15 isolates were identified as C. parvum with family subtypes IIa (n = 7) and IId (n = 8), while five were identified as C. hominis (family subtypes Ia (n = 2) and Ib (n = 3)) and two as C. felis. The C. parvum subtype families IIa and IId predominated, suggesting potential zoonotic transmission. More extensive sampling of both humans and farm animals, especially sheep, goats and calves, as well as a collection of epidemiological data are needed for a better understanding of the sources of human C. parvum infections in Algeria.
Background Cryptosporidium is a significant cause of chronic diarrhoea and death in HIV-infected patients. Although HIV-infected patients under HAART have currently reduced risk of suffering from opportunistic infections, opportunistic gastrointestinal infections such as cryptosporidiosis still occur. Currently, there are no data on genetic characteristics of Cryptosporidium isolates from cryptosporidiosis patients in Algeria. This study was aimed at identifying Cryptosporidium species and subtype families prevalent in Algerian HIV-infected patients and contributing to the molecular epidemiology mapping of Cryptosporidium in the MENA region. Methods From 2016 to 2018, 350 faecal specimens were obtained from patients with an HIV/AIDS positive status associated with diarrhoea attending inpatient (hospitalisation) and outpatient care units of El Hadi Flici (ex El- Kettar) hospital, Alger city, Algeria, and screened for the presence of Cryptosporidium using microscopy. Positive samples were submitted to the "Centre National de Reference-Laboratoire Expert- Cryptosporidioses", Rouen University Hospital, France, for molecular analysis (species, genotype) by DNA sequencing of the SSU18S rRNA and Gp60 genes, respectively. Results Out of 350 samples, 33 (9.4%) were microscopically positive for Cryptosporidium spp. of which 22 isolates were successfully amplified at the 18S rRNA and gp60 loci. Based on sequence analysis: 15 isolates were identified as C. parvum with family subtypes IIa-7, and IId-8, while 5 were identified as C. hominis (family subtypes Ia-2 and Ib-3) and 2 as C. felis . Conclusion The predominance of C. parvum subtype families IIa and IId in this study highlights the potential importance of zoonotic cryptosporidiosis transmission to Algerian HIV- positive subjects. More extensive sampling of both humans and farm animals, especially sheep, goats and calves, and collection of epidemiological data are needed for better understanding of the sources of human C. parvum infections in Algeria.
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