Intestinal parasitic infections in HIV/AIDS patients: epidemiological, nutritional and immunological aspects

Abstract

This study applied a socioeconomic questionnaire designed to evaluate the frequency of intestinal parasites and characterize epidemiological, nutritional, and immunological variables in 105 HIV/AIDS patients -with and without parasitic infections, attending the Day Hospital in Botucatu, UNESP, from 2007 to 2008. Body mass index was calculated and the following tests performed: parasitological stool examinations; eosinophil, IgE, CD4 + T and CD8 + T lymphocyte cell counts; albumin test; viral load measure; and TNF-α, IFN-γ, IL-2, IL-5 and IL-10 cytokine levels. Results were positive for parasitic intestinal infections in 12.4% of individuals. Most patients had good socioeconomic conditions with basic sanitation, urban dwellings, treated water supply and sewage, good nutritional and immunological status and were undergoing HAART. Parasites were found at the following frequencies: Entamoeba -five patients (38.5%), Giardia lamblia -four (30.7%), Blastocystis hominis -three (23.0%), Endolimax nana -two (15.4%), and Ascaris lumbricoides -one (7.7%). There were no significant differences between the two groups for eosinophils, albumin, IgE, CD4 + T and CD8 + T lymphocytes, INF-γ, IL-2, or IL-10. Most patients also showed undetectable viral load levels. Significant differences were found for TNF-α and IL-5. These results show the importance of new studies on immunodeficient individuals to increase understanding of such variables.

Enteric parasitic infection among antiretroviral therapy Naïve HIV-seropositive people: Infection begets infection-experience from Eastern India

“…POI was more in patients with low CD4 count (< 350/μl) which corroborates with other studies except the study by Amβncio where no association was found between CD4 count and POI. [ 2 3 6 7 8 10 11 ] In our study, Entameba was the most common POI in CD4 count < 350/μl while in CD4 count of 350/dl-500/μl and > 500/μl Cryptosporidium was the most common POI, in contrast to the study by Kulkarni et al ., where Cryptosporidium was the most common pathogen in CD4 count < 200/μl, Entameba was the most common parasite in 200-499/μl, and Hymenolepis was most common POI in CD4 count > 500 cells/μl. [ 2 ] In our study, multiple POIs among HIV-seropositive cases were associated with significantly lower CD4 count similar to the study by Dwivedi et al .…”

“…This may be attributable to significant association of tumor necrosis factor-α and interleukin-5 and other cytokines both with TB and POI and also poor socioeconomic and sanitary status. [ 10 20 21 ] In our study, among the HIV-seropositive patients, lower level of hemoglobin level (<10 g/dl) was found to be significantly associated with POI probably due to gastrointestinal blood loss. Higher absolute eosinophil count (>540/dl) was a significant association with POI unlike the study by Amβncio et al .…”

“…[ 1 2 3 ] In developed countries where most HIV infections occur among heterosexual persons, whereas in developing countries such as India, water- and food-borne transmissions are the principal modes of transmission of enteric organisms. [ 4 5 6 7 8 9 10 11 ] The severity and duration of symptoms associated with enteric pathogens are determined by level of immunosuppression, distribution of enteric parasitic pathogens, and clinical profiles of the HIV patients. [ 4 5 6 ] These parasitic opportunistic infections (POIs) are not only associated with symptomatic HIV-infected patients but also are more evident with decreasing immune state (CD4 + cell count < 200 cells/μl).…”

Intestinal parasites in cancer patients in the South of Brazil

“…Of the 73 participants in the study, 45 (61.6%) were positive for one or more parasitic species, a similar index to that found in other studies, such as a 66.7% figure found in cancer patients in Brazil (Silva et al, 2011). The most frequent parasite was Ascaris lumbricoides (33.3%), which showed a much higher prevalence than that found in AIDS patients in Brazil (7.7%) (Amancio et al, 2012). Infection by A. lumbricoides associated with other immunosuppressive diseases has been described in other studies and may be related to a wide prevalence of this helminth in humans around the world (Lau et al, 2007;Brum et al, 2013).…”

Prevalence of Blastocystis sp. infection in several hosts in Brazil: a systematic review and meta-analysis

“…Rebolla et al [51] Amâncio et al [57] Amato-Neto et al [72] Cimerman et al [74] Guimarães et al [77] Guimarães et al [75] Subtotal (I^2 = 99.17%, p = 0.00)…”