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Prevalence of isosporiasis in relation to CD4 cell counts among HIV-infected patients with diarrhea in Odisha, India.

Mohanty I, Panda P, Sahu S, Dash M, Narasimham MV, Padhi S, Parida B - Adv Biomed Res (2013)

Bottom Line: The mean CD4 cell count of HIV-positive patients with diarrhea suffering from isosporiasis was 138.35 ± 70.71.In patients with CD4 cell counts <200/μl, I. belli was seen in 36/123 stool samples and 2/27 stool samples which was statistically significant (P = 0.0157).This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, ART Centre, M.K.C.G. Medical College, Berhampur, Odisha, India.

ABSTRACT

Background: To determine the prevalence of Isospora belli and its correlation with CD4+ cell counts in HIV-positive patients with diarrhea in this region.

Materials and methods: Stool samples from 250 HIV-positive patients, including 200 with diarrhea and 50 without diarrhea included in the study were examined for the presence of enteric parasites under microscopy. Prevalence of the enteric parasites with special reference to I. belli in HIV-positive patients with and without diarrhea were calculated and correlated with their CD4+ cell counts.

Results: Enteric parasites were detected in 39% of the HIV patients with diarrhea compared to 30% without diarrhea. I. belli was detected in 22% of the patients with diarrhea and in 4% without diarrhea (P = 0.0019). I. belli was the most common parasite, followed by Entamoeba histolytica/dispar (8%) and Cryptosporidium parvum (5%) in HIV-positive patients with diarrhea. In HIV-positive patients without diarrhea, the most common parasite detected was E. histolytica/dispar (12%) followed by C. parvum (6%) and I. belli (4%). The mean CD4 cell count of HIV-positive patients with diarrhea suffering from isosporiasis was 138.35 ± 70.71. In patients with CD4 cell counts <200/μl, I. belli was seen in 36/123 stool samples and 2/27 stool samples which was statistically significant (P = 0.0157).

Conclusion: I. belli was the predominant parasite with a prevalence of 22% among HIV-positive patients with diarrhea, majority having CD4 cell count <200/μl. This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

No MeSH data available.


Related in: MedlinePlus

Microphotograph showing acid fast Isospora belli in stool sample
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Figure 1: Microphotograph showing acid fast Isospora belli in stool sample

Mentions: A total of 250 stool samples from HIV-infected patients were studied which included a study group of 200 patients with diarrhea and a control group of 50 patients without diarrhea. The mean age of the patients with diarrhea was 34.93 (SD 6.89; median 35) and those without diarrhea was 32.50 (SD 7.55; median 32). The ages ranged from 21 to 55 years. Out of the 200 HIV-positive patients with diarrhea, 118 (59%) were male and 82 (41%) were female. Even in the control group, there was male (66%) preponderance. Enteric parasites were seen in 78 (39%) stool samples in the study group and in 15 (30%) stool samples in the control group. In the study group, the most common parasite seen was I. belli (22%), [Figure 1], followed by Entamoeba histolytica/dispar (8%), Cryptosporidium spp. (5%), Microsporidium spp. (2%), Giardia lamblia (1%), and Ascaris lumbricoides and Strongyloides stercoralis (0.5% each). In the control group (HIV-positive without diarrhea), the most common entero-parasite detected was E. histolytica/dispar (12%), followed by Cryptosporidium spp. (6%), I. belli0 (4%) and A. lumbricoides, A. duodenale, Cyclospora cayetenensis and Microsporidium spp. (2% each) [Table 1]. The association of I. belli infection among HIV-positive individuals with diarrhea was significant (P = 0.0019, Fisher's extract test).


Prevalence of isosporiasis in relation to CD4 cell counts among HIV-infected patients with diarrhea in Odisha, India.

Mohanty I, Panda P, Sahu S, Dash M, Narasimham MV, Padhi S, Parida B - Adv Biomed Res (2013)

Microphotograph showing acid fast Isospora belli in stool sample
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814542&req=5

Figure 1: Microphotograph showing acid fast Isospora belli in stool sample
Mentions: A total of 250 stool samples from HIV-infected patients were studied which included a study group of 200 patients with diarrhea and a control group of 50 patients without diarrhea. The mean age of the patients with diarrhea was 34.93 (SD 6.89; median 35) and those without diarrhea was 32.50 (SD 7.55; median 32). The ages ranged from 21 to 55 years. Out of the 200 HIV-positive patients with diarrhea, 118 (59%) were male and 82 (41%) were female. Even in the control group, there was male (66%) preponderance. Enteric parasites were seen in 78 (39%) stool samples in the study group and in 15 (30%) stool samples in the control group. In the study group, the most common parasite seen was I. belli (22%), [Figure 1], followed by Entamoeba histolytica/dispar (8%), Cryptosporidium spp. (5%), Microsporidium spp. (2%), Giardia lamblia (1%), and Ascaris lumbricoides and Strongyloides stercoralis (0.5% each). In the control group (HIV-positive without diarrhea), the most common entero-parasite detected was E. histolytica/dispar (12%), followed by Cryptosporidium spp. (6%), I. belli0 (4%) and A. lumbricoides, A. duodenale, Cyclospora cayetenensis and Microsporidium spp. (2% each) [Table 1]. The association of I. belli infection among HIV-positive individuals with diarrhea was significant (P = 0.0019, Fisher's extract test).

Bottom Line: The mean CD4 cell count of HIV-positive patients with diarrhea suffering from isosporiasis was 138.35 ± 70.71.In patients with CD4 cell counts <200/μl, I. belli was seen in 36/123 stool samples and 2/27 stool samples which was statistically significant (P = 0.0157).This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

View Article: PubMed Central - PubMed

Affiliation: Department of Microbiology, ART Centre, M.K.C.G. Medical College, Berhampur, Odisha, India.

ABSTRACT

Background: To determine the prevalence of Isospora belli and its correlation with CD4+ cell counts in HIV-positive patients with diarrhea in this region.

Materials and methods: Stool samples from 250 HIV-positive patients, including 200 with diarrhea and 50 without diarrhea included in the study were examined for the presence of enteric parasites under microscopy. Prevalence of the enteric parasites with special reference to I. belli in HIV-positive patients with and without diarrhea were calculated and correlated with their CD4+ cell counts.

Results: Enteric parasites were detected in 39% of the HIV patients with diarrhea compared to 30% without diarrhea. I. belli was detected in 22% of the patients with diarrhea and in 4% without diarrhea (P = 0.0019). I. belli was the most common parasite, followed by Entamoeba histolytica/dispar (8%) and Cryptosporidium parvum (5%) in HIV-positive patients with diarrhea. In HIV-positive patients without diarrhea, the most common parasite detected was E. histolytica/dispar (12%) followed by C. parvum (6%) and I. belli (4%). The mean CD4 cell count of HIV-positive patients with diarrhea suffering from isosporiasis was 138.35 ± 70.71. In patients with CD4 cell counts <200/μl, I. belli was seen in 36/123 stool samples and 2/27 stool samples which was statistically significant (P = 0.0157).

Conclusion: I. belli was the predominant parasite with a prevalence of 22% among HIV-positive patients with diarrhea, majority having CD4 cell count <200/μl. This study highlights the importance of routine screening for coccidian parasites in HIV-positive patients with and without diarrhea especially in those with low CD4 cell counts.

No MeSH data available.


Related in: MedlinePlus