Co-infection of HIV and intestinal parasites in rural area of China

Particle and Fibre Toxicology

Xiao-Nong Zhou⁴  Li Zhou²  Jian Guo⁴  Xiao-Mei Yin²  Yu-Chun Cai⁴  Feng-Feng Wang²  Peter Steinmann¹  Guo-Jin Cheng³  Tian-Ping Wang²  Jia-Xu Chen⁴  Li-Guang Tian⁴ 

[1] University of Basel, 4051 Basel, Switzerland;Anhui Institute of Parasitic Disease Control, Wuhu 241000, China;Fuyang Center for Disease Control and Prevention, Fuyang 236000, China;National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis, Key Laboratory of Parasite & Vector Biology Ministry of Health, Shanghai 200025, China

关键词: China;    Co-infection;    Protozoa;    Helminths;    Intestinal parasites;    HIV;   

Others  :  1233079
DOI  :  10.1186/1756-3305-5-36

 received in 2011-11-15, accepted in 2012-02-13,  发布年份 2012

【 摘 要 】

Background

Intestinal parasite infections (IPIs) are among the most significant causes of illness and disease of socially and economically disadvantaged populations in developing countries, including rural areas of the People's Republic of China. With the spread of the human immunodeficiency virus (HIV) among rural Chinese populations, there is ample scope for co-infections and there have been increasing fears about their effects. However, hardly any relevant epidemiological studies have been carried out in the country. The aim of the present survey was to assess the IPI infection status among a representative sample of HIV-positive Chinese in rural Anhui province, and compare the findings with those from a cohort of non-infected individuals.

Methods

A case control study was carried out in a rural village of Fuyang, Anhui province, China. Stool samples of all participants were examined for the presence of intestinal parasites. Blood examination was performed for the HIV infection detection and anemia test. A questionnaire was administered to all study participants.

Results

A total of 302 HIV positive and 303 HIV negative individuals provided one stool sample for examination. The overall IPI prevalence of intestinal helminth infections among HIV positives was 4.3% (13/302) while it was 5.6% (17/303) among HIV negatives, a non-significant difference. The prevalence of protozoa infections among HIV positives was 23.2% while the rate was 25.8% among HIV negatives. The species-specific prevalences among HIV positives were as follows: 3.6% for hookworm, 0.7% for Trichuris trichiura, zero for Ascaris lumbricoides, 0.3% for Clonorchis sinensis, 1.3% for Giardia intestinalis, 16.2% for Blastocystis hominis, 1.7% for Entamoeba spp. and 8.3% for Cryptosporidium spp.. Cryptosporidium spp. infections were significantly more prevalent among HIV positives (8.3%) compared to the HIV negative group (3.0%; P < 0.05). Among people infected with HIV, Cryptosporidium spp. was significantly more prevalent among males (12.6%) than females (4.4%; P < 0.05). According to multivariate logistic regression, the factors significantly associated with parasite infections of the people who were HIV positive included sex (male: OR = 6.70, 95% CI: 2.030, 22.114), younger age (less than 42 years old: OR = 4.148, 95% CI: 1.348, 12.761), and poor personal hygiene habits (OR = 0.324, 95% CI: 0.105, 0.994).

Conclusions

HIV positive individuals are more susceptible to co-infections with Cryptosporidium spp. than HIV negative people, particularly younger males with poor personal hygiene habits, indicating a need for targeted hygiene promotion, IPI surveillance and treatment.

【 授权许可】

   
2012 Tian et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Xu LQ, Chen YD, Sun FH: A national survey on current status of the important parasitic diseases in human population. Chin J Parasitol Parasit Dis 2005, 23:332-340. (in Chinese)
• [2]Shao Y: AIDS epidemic at age 25 and control efforts in China. Retrovirology 2006, 3:87. BioMed Central Full Text
• [3]Tian LG, Steinmann P, Chen JX, Chen SH, Zhou XN: HIV/AIDS, parasites and co-infections: publication patterns in China. Parasit Vectors 2009, 2:31. BioMed Central Full Text
• [4]Newton CR: Interaction between Plasmodium falciparum and human immunodeficiency virus type 1 on the central nervous system of African children. J Neurovirol 2005, 11:Suppl 3: 45-51.
• [5]Gopinath R, Ostrowski M, Justement SJ, Fauci AS, Nutman TB: Filarial infections increase susceptibility to human immunodeficiency virus infection in peripheral blood mononuclear cells in vitro. J Infect Dis 2000, 182:1804-1808.
• [6]Harms G, Feldmeier H: HIV infection and tropical parasitic diseases - deleterious interactions in both directions? Trop Med Int Health 2002, 7:479-488.
• [7]Karanja DM, Colley DG, Nahlen BL, Ouma JH, Secor WE: Studies on schistosomiasis in western Kenya: I: Evidence for immune-facilitated excretion of schistosome eggs from patients with Schistosoma mansoni and human immunodeficiency virus coinfections. Am J Trop Med Hyg 1997, 56:515-521.
• [8]Tawill SA, Gallin M, Erttmann KD, Kipp W, Bamuhiiga J: Impaired antibody responses and loss of reactivity to Onchocerca volvulus antigens by HIV-seropositive onchocerciasis patients. Trans R Soc Trop Med Hyg 1996, 90:85-89.
• [9]Karp CL, Auwaerter PG: Coinfection with HIV and tropical infectious diseases. II: Helminthic, fungal, bacterial, and viral pathogens. Clin Infect Dis 2007, 45:1214-1220.
• [10]Nielsen NO, Simonsen PE, Dalgaard P, Krarup H, Magnussen P: Effect of diethylcarbamazine on HIV load, CD4%, and CD4/CD8 ratio in HIV-infected adult Tanzanians with or without lymphatic filariasis: randomized double-blind and placebo-controlled cross-over trial. Am J Trop Med Hyg 2007, 77:507-513.
• [11]Corbett EL, Steketee RW, ter Kuile FO, Latif AS, Kamali A: HIV-1/AIDS and the control of other infectious diseases in Africa. Lancet 2002, 359:2177-2187.
• [12]Tian LG, Zhou XN: Intestinal parasitic infections neglected in the HIV/AIDS patients. Chin J Parasitol Parasit Dis 2008, 26:376-381 (in Chinese).
• [13]Fincham JE, Markus MB, Adams VJ: Could control of soil-transmitted helminthic infection influence the HIV/AIDS pandemic. Acta Trop 2003, 86:315-333.
• [14]Unicef UNU. WHO: Iron deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva; 2001. WHO
• [15]Katz N, Chaves A, Pellegrino J: A simple device for quantitative stool thick-smear technique in schistosomiasis mansoni. Rev Inst Med Trop Sao Paulo 1972, 14:397-400.
• [16]Koga K, Kasuya S, Khamboonruang C, Sukhavat K, Ieda M: A modified agar plate method for detection of Strongyloides stercoralis. Am J Trop Med Hyg 1991, 45:518-521.
• [17]Taamasri P, Leelayoova S, Rangsin R, Naaglor T, Ketupanya A: Prevalence of Blastocystis hominis carriage in Thai army personnel based in Chonburi, Thailand. Mil Med 2002, 167:643-646.
• [18]Arikan S, Ergüven S, Aky n Y, Günalp A: Cryptosporidiosis in immunocompromised patients in a Turkish university hospital. Acta Microbiol Immunol Hung 1999, 46:33-40.
• [19]Qu FY: Historical review on the development of medical parasitology in China during the years of 1871-2006. Chin J Parasitol Parasit Dis 2007, 25:259-273. (in Chinese)
• [20]Mohandas K, Sehgal R, Sud A, Malla N: Prevalence of intestinal parasitic pathogens in HIV-seropositive individuals in Northern India. Jpn J Infect Dis 2002, 55:83-84.
• [21]Wiwanitkit V: Intestinal parasitic infections in Thai HIV-infected patients with different immunity status. BMC gastroenterol 2001, 1:3. BioMed Central Full Text
• [22]Nielsen NO, Simonsen PE, Magnussen P, Magesa S, Friis H: Cross-sectional relationship between HIV, lymphatic filariasis and other parasitic infections in adults in coastal northeastern Tanzania. Trans R Soc Trop Med Hyg 2006, 100:543-550.
• [23]Nielsen NO, Friis H, Magnussen P, Krarup H, Magesa S: Co-infection with subclinical HIV and Wuchereria bancrofti, and the role of malaria and hookworms, in adult Tanzanians: infection intensities, CD4/CD8 counts and cytokine responses. Trans R Soc Trop Med Hyg 2007, 101:602-612.
• [24]Zhang XP, Li LH, Zhu Q, Fu YH, Ma XJ: Investigation on the infection of Blastocystis hominis in various populations in Shanghai, China. J Pathog Biol 2008, 3:693-710. (in Chinese)
• [25]Su ZL, Su SL, Wu ZF, Miao H, Miao Y, Xie QJ, Zhang QS: Survey epidemiology of Blastocystis hominis infection in Ganzhou. J Pathog Biol 2008, (3):142-143. (in Chinese)
• [26]Zhang HW, Yan QY, He LJ, Su YP, Li W: Survey on asymptomtic Blastocystis hominis and its PCR identification. J Med Forum 2006, 27:32-36. (in Chinese)
• [27]Li CP, Wang J: Epidemiology investigation of Blastocystis hominis in Huainan areas. NEGATIVE 2002, 23:1480-1482. (in Chinese)
• [28]Zhou HF, Yan JL, Li JY: Current status of the important parasitic diseases in Luwan district. J Trop Med 2006, 6:1203-1204 (in Chinese).
• [29]Li LH, Zhang XP, Lv S, Zhang L, Yoshikawa H: Cross-sectional surveys and subtype classification of human Blastocystis isolates from four epidemiological settings in China. Parasitol Res 2007, 102:83-90.
• [30]Li LH, Zhou XN, Du ZW, Wang XZ, Wang LB: Molecular epidemiology of human Blastocystis in a village in Yunnan province, China. Parasitol Int 2007, 56:281-286.
• [31]Pinlaor S, Mootsikapun P, Pinlaor P, Pipitgool V, Tuangnadee R: Detection of opportunistic and non-opportunistic intestinal parasites and liver flukes in HIV-positive and HIV-negative subjects. Southeast Asian J Trop Med Public Health 2005, 36:841.
• [32]Gassama A, Sow PS, Fall F, Camara P, Philippe H: Ordinary and opportunistic enteropathogens associated with diarrhea in Senegalese adults in relation to human immunodeficiency virus serostatus. Int J Infect Dis 2001, 5:192-198.
• [33]Deodhar L, Maniar JK, Saple DG: Cyclospora infection in acquired immunodeficiency syndrome. J Assoc Physicians India 2000, 48:404-406.
• [34]Garcia C, Rodriguez E, Do N, López de Castilla D, Terashima A, Gotuzzo E, Terashima A: Intestinal parasitosis in patients with HIV-AIDS. Rev Gastroenterol Peru 2006, 26:21-24.
• [35]Noureldin MS, Shaltout AA, El Hamshary EM, Ali ME: Opportunistic intestinal protozoal infections in immunocompromised children. J Egy Soc Parasitol 1999, 29:951.
• [36]Hunter PR, Hughes S, Woodhouse S, Syed Q, Verlander NQ, Chalmers RM, Morgan K, Nichols G, Beeching N, Osborn K: Sporadic cryptosporidiosis case-control study with genotyping. Emerg Infect Dis 2004, 10:1241-1249.
• [37]Benczik M, Gaffen SL: The interleukin (IL)-2family cytokines: survival and proliferation signaling pathways in T lymphocytes. Immunol Invest 2004, 33:109-142.
• [38]Cama V, Gilman RH, Vivar A, Ticona E, Ortega Y, Bern C, Xiao L: Mixed Cryptosporidium infections and HIV. Emerg Infect Dis 2006, 12:1025-1028.
• [39]Tanriverdi S, Arslan M, Akiyoshi DE, Tzipori S, Widmer G: Identification of genotypically mixed Cryptosporidium parvum populations in humans and calves. Mol Biochem Parasitol 2003, 130:13-22.
• [40]Xiao L, Ryan UM: Cryptosporidiosis: an update in molecular epidemiology. Curr Opinion Infect Dis 2004, 17:483-490.
• [41]Llorente MT, Clavel A, Goñi MP, Varea M, Seral C, Becerril R, Suarez L, Gómez-Lus R: Genetic characterization of Cryptosporidium species from humans in Spain. Parasitol Int 2007, 56:201-205.
• [42]Donato Traversa: Evidence for a new species of Cryptosporidium infecting tortoises: Cryptosporidium ducismarci. Parasite Vectors 2010, 3:21. BioMed Central Full Text