Lower prevalence of Blastocystis sp. infections in HIV positive compared to HIV negative adults in Ghana

Abstract

Background Sub-Saharan Africa is endemic for intestinal parasites and distinguished for the largest burden of HIV cases. Blastocystis sp. is one of the most common protists infecting humans but its role in human disease is still controversial. Aim of this study was to investigate the prevalence of Blastocystis sp. in HIV positive and negative adults in Ghana and its association with immune status and other risk factors. Methods 122 HIV positive outpatients and 70 HIV negative blood donors from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, were included in the present study. Demographic, clinical and laboratory data were collected and HIV positive patients distinguished for CD4+ T cell count <200 cells/μl (n = 54) and >200 cells/μl (n = 68). A Blastocystis ’s phylogenetic analysis was performed to determine sample subtype (ST). Results The prevalence of Blastocystis sp. in adult HIV positive individuals was lower than in HIV negative persons (6.6% vs. 20.0%, p = 0.008) and Blastocystis sp. ST1 was the most prevalent strain. Within HIV positive participants, the prevalence of Blastocystis sp. was lower in those individuals with CD4+ T cell count <200 cells/μl than in patients with higher CD4+ T cell count (1.9% vs. 10.3%, p = 0.076). Multiple regression analysis revealed that Blastocystis sp. was inversely associated with an obese Body Mass Index (BMI) in HIV negative persons (p = 0.040). Presence of Blastocystis sp. was correlated with higher CD4+ T cell count in HIV positive participants (p = 0.049). Conclusion It is largely reported that people living with HIV (PLHIV) in Africa are affected from parasite infections and that co-infections may adversely impact on their immune status, accelerating progress to AIDS and worsening gastrointestinal manifestations. Differently, in this study Blastocystis sp. was associated with a better immune status jointly with a healthy body weight while it seems to be reduced with the progression of HIV infection. This data agree with recent suggestions that Blastocystis sp. can represent a component of the healthy gut microbiota.

Relative Frequency of Blastocystis Subtypes 1, 2, and 3 in Urban and Periurban Human Populations of Arequipa, Peru

“…Over the last decade, Blastocystis has been studied widely, but it remains unclear whether it is pathogenic [ 8 ]. Some studies report an association between Blastocystis and gastrointestinal symptoms, such as abdominal pain, diarrhea, vomiting, constipation, and irritable bowel syndrome (IBS) [ 5 , 9 , 10 ], whereas other investigations failed to prove any correlation between Blastocystis and health issues [ 11 , 12 ] or suggest that Blastocystis could be considered normal or beneficial for the microbiota [ 13 , 14 ]. Blastocystis transmission is generally associated with poor access to healthcare and unsanitary living conditions around the world [ 3 , 15 ].…”

Molecular epidemiology of Blastocystis in urban and periurban human populations in Arequipa, Peru

“…The copyright holder for this preprint this version posted June 20, 2020. ; https://doi.org/10.1101/2020.06.17.20134064 doi: medRxiv preprint to showed associating Blastocystis with a healthy microbiome (8,9), a rich diet in vegetables (53) and a better immune status (7). Some studies found a positive correlation between Blastocystis and bacterial richness which suggests that Blastocystis is most common in people with healthy bacterial flora and negative correlated to Bacteroides that is observed more prevalent in unhealthy people being able to use Blastocystis as to determine the health of the individual rather than the bacterial composition (8,9,54).…”

“…Blastocystis is a protozoa found in the gut of humans and animals (1,2), but it remains unclear whether it is pathogenic (3). Some researchers report an association between Blastocystis and gastrointestinal symptoms and diseases (4,5) whereas other investigations fail to prove any correlation between both (6,7) or suggest Blastocystis could be consider as normal or beneficial for the microbiota (8,9).…”

Клініко-Епідеміологічні Особливості Паразитарної Інвазії Blastocystis Spp.

“…За даними різних досліджень, Blastocystis spр. виявляють у 10-15 % людей у розвинених країнах та 50-100 % -в країнах, що розвиваються [6,7] ................................................................................ [31]. За результатами нашого дослідження, при обстеженні 250 ВІЛ-позитивних пацієнтів і 170 клінічно здорових дорослих частота виявлення Blastocystis spр.…”