Impact factors of Blastocystis hominis infection in persons living with human immunodeficiency virus: a large-scale, multi-center observational study from China

Infectious Diseases of Poverty

Research Article

Ying-Fang Yu¹  Qin Liu¹  Shan Lv¹  Yan Lu¹  Li-Guang Tian¹  Xiao-Nong Zhou¹  Jin-Xin Zheng¹  Mu-Xin Chen¹  Xiu-Ping Wu¹  Wen-Wen Lv²  Ji-Chun Wang³  Zhong-Wei Li⁴  Guo-Bing Yang⁵  Lei Wang⁶  Pei-Yong Zheng⁶  Zhen-Hui Lu⁶  Ming Yang⁶  Yue-Lai Chen⁶  Shun-Xian Zhang⁷  Zhi-Hui Dou⁸  Wen-Ting Zhou⁹  Da-Wei Zhang^1,10 

[1] Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, 200025, Shanghai, China;School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;Department of Science and Technology, Chinese Center for Disease Control and Prevention, 102206, Beijing, China;Gansu Province People’s Hospital, Gansu Provincial Hospital, 730000, Lanzhou, China;Gansu Provincial Center for Disease Control and Prevention, 730000, Lanzhou, China;Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 200032, Shanghai, China;Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 200032, Shanghai, China;Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research On Tropical Diseases, National Institute of Parasitic Diseases, 200025, Shanghai, China;School of Global Health, Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China;National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, 102206, Beijing, China;National Health Commission (NHC) Key Laboratory of Biosafety, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 102206, Beijing, China;The People’s Liberation Army 302 Hospital, 100039, Beijing, China;

关键词: Blastocystis hominis;    Human immunodeficiency virus;    Viral load;    Non-linear association;    Restricted cubic spline;    Propensity score;    China;   

DOI  :  10.1186/s40249-023-01137-5

 received in 2023-06-08, accepted in 2023-09-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundBlastocystis hominis (Bh) is zoonotic parasitic pathogen with a high prevalent globally, causing opportunistic infections and diarrhea disease. Human immunodeficiency virus (HIV) infection disrupts the immune system by depleting CD4+ T lymphocyte (CD4+ T) cell counts, thereby increasing Bh infection risk among persons living with HIV (PLWH). However, the precise association between Bh infection risk and HIV-related biological markers and treatment processes remains poorly understood. Hence, the purpose of the study was to explore the association between Bh infection risk and CD4+ T cell counts, HIV viral load (VL), and duration of interruption in antiviral therapy among PLWH.MethodsA large-scale multi-center cross-sectional study was conducted in China from June 2020 to December 2022. The genetic presence of Bh in fecal samples was detected by real-time fluorescence quantitative polymerase chain reaction, the CD4+ T cell counts in venous blood was measured using flowcytometry, and the HIV VL in serum was quantified using fluorescence-based instruments. Restricted cubic spline (RCS) was applied to assess the non-linear association between Bh infection risk and CD4+ T cell counts, HIV VL, and duration of interruption in highly active antiretroviral therapy (HARRT).ResultsA total of 1245 PLWH were enrolled in the study, the average age of PLWH was 43 years [interquartile range (IQR): 33, 52], with 452 (36.3%) being female, 50.4% (n = 628) had no immunosuppression (CD4+ T cell counts > 500 cells/μl), and 78.1% (n = 972) achieved full virological suppression (HIV VL < 50 copies/ml). Approximately 10.5% (n = 131) of PLWH had interruption. The prevalence of Bh was found to be 4.9% [95% confidence interval (CI): 3.8–6.4%] among PLWH. Significant nonlinear associations were observed between the Bh infection risk and CD4+ T cell counts (Pfor nonlinearity < 0.001, L-shaped), HIV VL (Pfor nonlinearity < 0.001, inverted U-shaped), and duration of interruption in HARRT (Pfor nonlinearity < 0.001, inverted U-shaped).ConclusionsThe study revealed that VL was a better predictor of Bh infection than CD4+ T cell counts. It is crucial to consider the simultaneous surveillance of HIV VL and CD4+ T cell counts in PLWH in the regions with high level of socioeconomic development. The integrated approach can offer more comprehensive and accurate understanding in the aspects of Bh infection and other opportunistic infections, the efficacy of therapeutic drugs, and the assessment of preventive and control strategies.Graphical Abstract

【 授权许可】

CC BY   
© National Institute of Parasitic Diseases 2023

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