Association between CD4+ cell count, intestinal parasites and diarrhea in HIV-infected patients at Khartoum State, Sudan (2007-2010)‎

Dissertant

Kubbarah, Usamah Sayyid

Thesis advisor

Abd Allah, Hamid Sulayman

University

Omdurman Islamic University

Faculty

Faculty of Medical Laboratory

Department

Department of Medical Parasitology & Entomology

University Country

Sudan

Degree

Ph.D.

Degree Date

2011

English Abstract

Protozoan infections pose serious threat in HIV patients.

The present study aimed to elucidate the associations between diarrhea and CD4 counts and to study the effect of HAART. The study was conducted on 657 HIV infected and non-infected patients confirmed by current rapid HIV testing algorithm.

A total of 423 HIV positive patients on and without-ART aged from3 to 65 years, of both sexes.

Stool samples were collected from patients at Bashier Teaching Hospital.

Out of 657 stool samples, 423 were collected from HIV positive patients with and without diarrhea and 234 from HIV negative patients.

Parasite infections were diagnosed by examination single stool specimens as fresh wet mount preparation (saline, Lugol’s iodine), formol-ether concentration technique and staining (modified Ziehl Neelsen staining).CD4 counts were recorded to assess the status of HIV infection vis-à-vis parasitic infection The results showed that diarrhea was more prevalent inHIVinfected 279(66 %) than non-infectedpatients (3 %).

Regardless of their diarrhea status, the general prevalence of intestinal parasites in HIV infected and non-infected were 73% and 15% respectively.

Among the 423infected patients 56 (13 %) and 223(53 %) had chronic and acute diarrhea respectively.

The prevalence of intestinal parasites was 125(30%)in patients with chronic and 137(32 %) in acute diarrhea.

Cryptosporidium parvum, and Isosporabelli, oocyst were detected only in HIV infected patients with chronic diarrhea (P<0.001).The prevalence was 22 % for Giardia lamblia, 14 % for Entamoeba histolytica, 12 % for Cryptosporidium parvum, 8 % for Isospora belli, 10 % for Strongyloides stercoralis, 1 % for Taenia spp and 2 % for Hymenolepisnana.

Diarrhea was significantly associated with cryptosporidiosis, giardiasis, and isosporiasis.

G.

lamblia, Entamoeba histolytica and Entamoebacoli were detected in stool samples of HIV infected and non-infected patients (P < 0.05).Patients with chronic diarrhea had lower CD4 cell counts.

The maximum parasitic load was noted in the patients with CD4 cell counts below 200 cells/μl.Significant association was observed between lower CD4 + T cell count (< 200 cells / µL) and the prevalence of Cryptosporidium parvum, Isospora belli, and Strongyloides stercoralis.

The three parasites were significantly prevalent in HIV sero-positive patients not on ART.

Immune restoration was observed in 93% patients after treatment on the basis of clinical observation and CD4 counts.

Based on the data, it was concluded that there was an inverse relation between the CD4 counts and duration of diarrhea.

Cryptosporidiumparvum was isolated maximum among all the parasites in the HIV patients.

The finding showed that patients under ART had lower prevalence of diarrheogenic protozoan parasites suggesting that ART, through improvement of the immune status of patients, may have contributed to controlling parasites in HIV / AIDS patients.

Main Subjects

Medicine

Topics

• Patients
• Intestines
• Aids
• Sudan
• Khartoum
• Diarrhea

No. of Pages

158

Table of Contents

• APA
• MLA
• AMA

Language

English

Data Type

Arab Theses

Record ID

BIM-367503