Intestinal parasitic infections in HIV/AIDS patients presenting with diarrhoea in Jakarta, Indonesia

Abstract

We investigated the occurrence of intestinal parasites in Indonesian HIV/AIDS patients with chronic diarrhoea prior to administering antiretroviral therapy. The influence of age, CD4(+) cell count and season on parasite occurrence was also studied. In total, 318 unconcentrated stool samples were analysed using Lugol's iodine and modified acid fast staining to detect intestinal coccidia. Most samples (94.5%) were from males aged 21-40 years with CD4(+) counts < or = 50 cells/mm(3). Parasites were found in 84.3% of samples (single species infections, 71.4%; polyparasitism, 12.9%), with protozoan pathogens occurring most commonly. Cryptosporidium (4.9%), Cyclospora cayetanensis (4.5%) and Giardia duodenalis (1.9%) were the most frequent single infections, but Blastocystis hominis (72.4%) was the most commonly occurring protist. Cryptosporidium and C. cayetanensis occurred in 11.9% and 7.8% of all (single and mixed) infections. The most common co-infection was with B. hominis and Cryptosporidium (6.3%). Intestinal protozoan pathogens were detected more frequently in cases with CD4(+) counts < or = 200/mm(3). No seasonal influence was determined for Cryptosporidium, C. cayetanensis or B. hominis, but gross seasonal disturbances may have influenced our findings. Intestinal parasites should be looked for routinely in this group of individuals and should be treated to reduce complications and the likelihood of transmission.

Prevalence of Intestinal Parasites in HIV-Positive Patients Attending Ahvaz Health Centers in 2012: A Cross-Sectional Study in South of Iran

“…The results indicated that the prevalence of intestinal parasitic infections in these patients was high. Studies from across the world on the intestinal parasites have reported high prevalence of these parasites in HIV-positive patients (11)(12)(13)(14), which is consistent with the present study. In a study in 2004 by Hailemariam et al in Ethiopia on 104 patients, it was found that of 78 HIV-positive patients, 41 patients (52.6%) and of 26 HIV-negative patients, 11 patients (42.32%) had gastrointestinal parasite infection; also multiple gastrointestinal parasite infections were common in these patients (15).…”

Intestinal parasitic and candida infection associated with HIV infection in Cameroon

“…Therefore, apart from the effects of HIV enteropathy, the presence of intestinal parasites is an important contributing factor to diarrhoea, which in the longer term could result in the wasting syndrome called "slim disease" [3,21]. In agreement with observations reported in previous studies [22,23], our investigation found that intestinal parasites associated with HIV were more likely encountered as the CD4 + count fell below 200 cells/μL, resulting in a higher prevalence of diarrhoea in this category of patients. As shown by Assefa et al [4], patients with severe immunodeficiency are more susceptible to acquire particular parasites and are also unable to clear established infections.…”

Sporadic Cryptosporidium infection in Nigerian children: risk factors with species identification

“…Previous research has shown that patients can be co-infected with Cryptosporidium and parasites such as Blastocystis hominis, Giardia spp., Entamoeba histolytica, Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis and Dicrocoelium dendriticum [27][28][29]. However, the majority of these studies simply detected the presence of these species through the analysis of stool samples, with few determining the physiological and immunological significance of such co-occurrences.…”