Intestinal Parasites Infections among HIV Infected Children Under Antiretrovirals Treatment in Yaounde, Cameroon

2019 ◽  
Vol 66 (2) ◽  
pp. 178-186
Author(s):  
William Baiye Abange ◽  
Celine Nguefeu Nkenfou ◽  
Hortense Gonsu Kamga ◽  
Clement Assob Nguedia ◽  
Nelly Kamgaing ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Intestinal Parasites ◽  
Parasitic Infection ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
Blood Samples ◽  
Cryptosporidium Spp ◽  
Cell Counts ◽  
Cd4 T Cell Count

Abstract Background Intestinal parasitic infections are among the most common communicable diseases worldwide, particularly in developing countries. Human immunodeficiency virus (HIV) causes dysregulation of the immune system through the depletion of CD4+ T lymphocytes which gives rise to opportunistic infections. Methodology A cross-sectional study was conducted from January to October 2018. Stool and blood samples were collected from participants aged 1 to 19. Stool samples were analyzed for intestinal parasites. Blood samples were analyzed for HIV and CD4 + T cell counts. Results Out of 214 children enrolled, 119 (55.6%) were HIV infected and 95 (44.4%) were HIV non-infected. All infected children were on antiretroviral treatment (ART). The prevalence of intestinal parasites was 20.2% in HIV infected and 15.8% in non-infected children. Among the 119 HIV infected children, 33 (27.7%) of them had a CD4+ T cell count less than 500 cells/mm3, and amongst them 5.9% had CD4+ T cell count less than 200 cells/mm3. Among HIV infected children, Cryptosporidium spp. was frequently detected, 7/119 (5.9%), followed by Giardia lamblia 5/119 (4.2%) then Blastocystis hominis 3/119 (2.5%) and Entamoeba coli 3/119 (2.5%). Participants on ART and prophylactic co-trimoxazole for >10 years had little or no parasite infestation. Conclusions Although ART treatment in combination with prophylactic co-trimoxazole reduces the risk of parasitic infection, 20.2% of HIV infected children harbored intestinal parasites including Cryptosporidium spp. Stool analysis may be routinely carried out in order to treat detected cases of opportunistic parasites and such improve more on the life quality of HIV infected children.

scholarly journals Prevalence of Intestinal parasitic infections in HIV infected patients presenting with diarrhea and their association with CD4+ Counts

2015 ◽  
Vol 3 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Desh D Singh ◽  
Vinod Singh
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Immune Status ◽  
Intestinal Parasites ◽  
Parasitic Infection ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
Intestinal Parasitic Infection ◽  
Cell Counts ◽  
Cd4 T Cell Count

Introduction: Intestinal parasitic infection has been an important problem in HIV patients, worldwide. Hence, this study was undertaken toestablish the prevalence of intestinal parasitic infection among people with and without HIV infection and its association with diarrhea andCD4 T-cell count. we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in peopleinfected with HIV. Methodology: An analytical cross-sectional study in 1490 HIV-infected people attending for CD4 T-cell count wasconducted. Results: The incidence of intestinal parasitic infection was 22.4% (95% CI 29.25 to 38.25). In univariate investigation, age, sex,longer time because diagnosis of HIV, CD4 T-cell count of <200/μL, diarrhoea, wedded status, and individual under tuberculosis (TB)treatment were drastically related with increased chances of intestinal parasite infection. Nevertheless, in the logistic malfunctionrepresentation, only the CD4 T-cell count of <200/μL (accustomed OR=6.3, 95% CI 3.75 to 10.5), diarrhoea (accustomed OR=4.2,95% CI 2.7 to 6.45) and individual under TB cure (adjusted OR=4.35, 95% CI 2.7 to 6.45) remain as significant predictors. Onstratification, CD4 T-cell count of <200/ μL was independently associated with higher odds of protozoal as well as helminthes infection. Theparasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/μL. Conclusions: HIV infectionincreased the risk of having intestinal parasites and diarrhoea. Therefore, raising HIV positive’s immune status and screening for intestinalparasites is important. This study showed that Immunodeficiency increased the risk of having opportunistic parasites and diarrhea. Therefore;raising patient immune status and screening at least for those treatable parasites is important.DOI: http://dx.doi.org/10.3126/ijasbt.v3i1.12203     Int J Appl Sci Biotechnol, Vol. 3(1): 96-100 

scholarly journals Intestinal parasitic infection among the HIV-infected patients in Nepal

2013 ◽  
Vol 7 (07) ◽  
pp. 550-555 ◽  
Author(s):  
Bishnu Raj Tiwari ◽  
Prakash Ghimire ◽  
Sarala Malla ◽  
Bimala Sharma ◽  
Surendra Karki
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Parasitic Infection ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
Intestinal Parasitic Infection ◽  
Infected People ◽  
Tb Treatment ◽  
Cell Counts ◽  
Cd4 T Cell Count

Introduction: Intestinal parasitic infection has been a significant problem in HIV patients, worldwide. In this study, we aimed to measure the prevalence and identify the factors associated with intestinal parasitic infection in people infected with HIV and attending National Public Health Laboratory in Kathmandu, Nepal, for CD4 T-cell count. Methodology: An analytical cross-sectional study in 745 HIV-infected people attending for CD4 T-cell count was conducted. Results: The prevalence of intestinal parasitic infection was 22.4% (95% CI 19.5 to 25.5). In univariate analysis, age, sex, longer time since diagnosis of HIV, CD4 T-cell count of <200/µL, diarrhoea, marital status, and being under tuberculosis (TB) treatment were significantly associated with increased odds of intestinal parasite infection. However, in the logistic regression model, only the CD4 T-cell count of <200/µL (adjusted OR=4.2, 95% CI 2.5 to 7.0), diarrhoea (adjusted OR=2.8, 95% CI 1.8 to 4.3) and being under TB treatment (adjusted OR=2.9, 95% CI 1.8 to 4.6) remained as significant predictors. On stratification, CD4 T-cell count of <200/ µL was independently associated with higher odds of protozoal as well as helminthes infection. The parasites Cryptosporidium and Cyclospora were observed only in participants with CD4 T-cell counts <200/µL. Conclusions: Both protozoal and helminthic intestinal parasitic infections are common in HIV-infected people seeking care in healthcare facilities. The poor immune status as indicated by low CD4 T-cell count and TB may account for such a high risk of parasitic infection.

scholarly journals Prevalence of intestinal parasitic infections among people living with HIV/AIDS visiting a central hospital of Kathmandu Nepal

2017 ◽  
Vol 8 (5) ◽  
pp. 87-92 ◽  
Author(s):  
Homa Nath Sharma ◽  
Bimal Shama Chalise ◽  
Ganesh Rai ◽  
Nabaraj Adhikari ◽  
Anup Bastola ◽  
...  
Keyword(s):  
T Cell ◽  
Intestinal Parasites ◽  
Parasitic Infection ◽  
Cd4 T Cell ◽  
Parasitic Infections ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Cell Counts ◽  
Living With Hiv ◽  
Hiv Aids

Backgrounds: Intestinal Parasitic Infection (IPI) plays a vital role in the prognosis of People Living with HIV/AIDS (PLHA).Aims and Objectives: In this study, we aimed to measure the prevalence and associated factors of IPI among PLHA and non-HIV patients attending Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu.Materials and Methods: A cross-sectional study was conducted among 193 PLHA and 111 non-HIV patients having either of gastrointestinal disorders. Direct smear, Formalin ethyl acetate sedimentation and Kinyoun’s modified acid fast staining methods were applied to detect intestinal parasites from stool samples and CD4 T-cell counts of PLHA was recorded from ART centre of hospital.Results: The overall prevalence of IPI was found to be 16.12% (19.17% in PLHA and 10.81% in non-HIV subjects). Prevalence was higher in PLHA (p<0.06) in which poly parasitic infection was common (24%) with the protozoa predominating over helminths. CD4 T-cell counts <200/μl (p<0.06) and diarrhoea (p<0.06) were associated with increased IPI in PLHA. Cryptosporidium parvum was found in 19.05% cases of PLHA having CD4 T-cell counts <200/μl.Conclusions: The higher prevalence of opportunistic protozoa among PLHA indicates the need of routine parasitic investigation using sensitive methods so that it will be helpful for the proper therapeutic management.Asian Journal of Medical Sciences Vol.8(5) 2017 87-92

scholarly journals PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  
Keyword(s):  
South Africa ◽  
T Cells ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Point Of Care ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Kwazulu Natal ◽  
Cd4 T Cell Count

Introduction: Limited information is available on the usefulness of the PIMATM analyser in predicting antiretroviral treatment eligibility and outcome in a primary healthcare clinic setting in disadvantaged communities in KwaZulu-Natal, South Africa.Materials and methods: The study was conducted under the eThekwini Health Unit, Durban, KwaZulu-Natal. Comparison of the enumeration of CD4+ T-cells in 268 patients using the PIMATM analyser and the predicate National Health Laboratory Services (NHLS) was undertaken during January to July 2013. Bland-Altman analysis to calculate bias and limits of agreement, precision and levels of clinical misclassification at various CD4+ T-cell count thresholds was performed.Results: There was high precision of the PIMATM control bead cartridges with low and normal CD4+ T-cell counts using three different PIMATM analysers (%CV < 5). Under World Health Organization (WHO) guidelines (≤ 500 cells/mm3), the sensitivity of the PIMATM analyser was 94%, specificity 78% and positive predictive value (PPV) 95%. There were 24 (9%) misclassifications, of which 13 were false-negative in whom the mean bias was 149 CD4+ T-cells/mm3. Most (87%) patients returned for their CD4 test result but only 67% (110/164) of those eligible (≤ 350 cells/mm3) were initiated on antiretroviral therapy (ART) with a time to treatment of 49 days (interquartile range [IQR], 42–64 days).Conclusion: There was adequate agreement between PIMATM analyser and predicate NHLS CD4+ T-cell count enumeration (≤ 500 cells/mm3) in adult HIV-positive individuals. The high PPV, sensitivity and acceptable specificity of the PIMATM analyser technology lend it as a reliable tool in predicting eligibility and rapid linkage to care in ART programmes.Keywords: HIV; Point of Care; PIMATM CD4+ T cell counts; antiretroviral therapy; prediction/eligibility; South Africa

Prognostic value of an immune score combining intra- and peritumoral T-cell subset density in patients with pancreatic adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4060-4060
Author(s):  
Simon Turcotte ◽  
Yannic McNicoll ◽  
Genevieve Soucy ◽  
Louis Gaboury ◽  
Real W. Lapointe ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Pancreatic Adenocarcinoma ◽  
Prognostic Value ◽  
Cd8 T Cell ◽  
Tnm Staging ◽  
Cd4 T Cell ◽  
Cell Counts ◽  
Immune Score ◽  
Cd4 T Cell Count

4060 Background: Immune scoring based on T-cell subsets and density can add prognostic value to conventional TNM staging for patients with solid tumors, but limited data are available for pancreatic adenocarcinoma. Methods: Using tissue microarrays, CD3, CD4, CD8, CD45RO, and FOXP3 T-cells were quantified by immunohistochemistry in the intratumoral (IT) compartment and peritumoral (PT) parenchyma of 111 consecutively resected specimens. T-cell counts were correlated with patient overall survival, disease-free survival, and time to recurrence (OS, DFS, TTR) by Cox regression, controlling for clinicopathological factors. An immune score (IS) based on IT CD4 T-cell count > median, PT CD8 T-cell count ≤ median, and IT/PT CD3 T-cell ratio >1, grouped patients into high, intermediate, or low categories if all 3, 1 to 2, or none of these immune features were present, respectively. Results: Median follow-up time was 20 months, and 85% of patients either died or recurred during the study period. By univariate analysis, PT CD8 T-cell count was associated with shorter OS (p=0.02), whereas both IT CD4 T-cell count and IT/PT CD3 T-cell ratio were associated with longer OS (p=0.01 and p=0.05, respectively). Alone, none of these immune features predicted TTR. Combined into an IS, patients in the high (n=23), intermediate (n=60), or low (n=23) categories had significantly different OS (respective medians 30, 17, and 13 months, log-rank p=0.01), DFS (28, 16, and 12 months, p=0.01), and TTR (21, 14, and 10 months, p=0.02). By multivariate analysis, the association between IS and clinical outcomes was independent of tumor size, extra-pancreatic invasion, and nodal metastases (TNM staging). The IS discriminated outcomes among patients with nodal metastases (n=80), such that node-positive patients with a high IS had a median survival similar to node-negative patients (30 and 33 months, p=0.7). FOXP3 and CD45RO T-cell counts did not appear to add prognostic value to the IS. Conclusions: An immune score that combines specific T-cell location and density may have prognostic value in patients with resected pancreatic adenocarcinoma, independently from pathologic features currently used for staging.

scholarly journals Determination of CD4+ T- Lymphocytes in Healthy Children of Kathmandu

2018 ◽  
Vol 16 (3) ◽  
pp. 325-329
Author(s):  
Sapana Karn ◽  
Manjula Bhattarai ◽  
Ramanuj Rauniyar ◽  
Anurag Adhikari ◽  
Pratik Karna ◽  
...  
Keyword(s):  
T Cell ◽  
Cord Blood ◽  
Cell Count ◽  
T Lymphocyte ◽  
Cd4 T Cell ◽  
Specific Reference ◽  
Healthy Children ◽  
Cross Sectional ◽  
Cell Counts ◽  
Cd4 T Cell Count

Background: The cluster differentiation (CD) of T-cell is the good marker for the immunological competence study. Nepal does not have a reference value for CD4+ T cell count and percentage for children, which severely limits the prospect of pediatric prognosis.Methods: This cross-sectional study was conducted in Kathmandu valley where total 207 children of age 0-14 year age group were recruited in this study. We analyzed 50 cord blood and 157 peripheral blood samples in order to calculate the absolute count of CD4+ T lymphocyte using Fluorescence-activated cell sorting methodology.Results: The reference range for absolute CD4+ T cell count was found to be 634-4040 cells/µL(mean1470; median: 1335 and 95% CI [1322-1617]) for male children and 491-2922 cells/µL (mean: 1443 median: 1326 and95% CI [1298-1588]) for the female children.We also observed elevated CD4 to the CD3 ratio in younger children (0.67 from cord blood Vs 0.53 from 10-14yr) compared to older ones.Conclusions: The observed CD4+ T cell counts among healthy children of Kathmandu highlights the gender differences skewed for male as well the need of defining specific reference values for other lymphocyte subsets as well in a country like Nepal which has a population with diverse genetic and socio-cultural parameters.Keywords: CD4+ T lymphocyte; children; HIV; immunophenotyping; Kathmandu; Nepal.

scholarly journals Prospective study of opportunistic infections among HIV infected patients in VSS Institute of Medical Science and Research, Burla, Sambalpur, Odisha, India

2018 ◽  
Vol 5 (3) ◽  
pp. 566
Author(s):  
P. K. Bariha ◽  
M. K. Mohapatra ◽  
B. K. Kullu ◽  
P. C. Karua ◽  
S. B. Biswal ◽  
...  
Keyword(s):  
T Cell ◽  
Prospective Study ◽  
Cell Count ◽  
Opportunistic Infections ◽  
Oral Candidiasis ◽  
Medical Science ◽  
Cd4 T Cell ◽  
Female Ratio ◽  
Cell Counts ◽  
Cd4 T Cell Count

Background: HIV destroys the CD4+T cells progressively thus making the HIV infected persons susceptible to a number of opportunistic infections (OIs).Methods: The study was conducted in the Medicine Department and ART Centre, VIMSAR. It is a prospective study from July 2016 to September 2017.Results: 86 patients register, detail history, clinical examination and investigation were done and then the data is complying in detail. Most of the patients were male (72%) male female ratio is 2.6:1. The majority of patients presented with fever, weight loss and anorexia seen in more than 73% of the study population.Conclusions: (42%) cases belonged to the CD4+T cell count range of 101-200/µl with aCD4+T cell count of 183/µl, so there is increased chance of hospitalization in patients having CD4+T cell count below 200/µl. The most common OI was tuberculosis (51%) with pleural effusion as its commonest manifestation. The second most common OI was candidiasis (43%) with most cases suffering from oral candidiasis was seen to occur at higher CD4+T cell counts than tuberculosis.

scholarly journals Human Immuno-Deficiency Virus Co-Infection with Hepatitis B Virus and Baseline CD4+ T Cell Count among Patients Attending a Tertiary Care Hospital, Nepal

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Developing Countries ◽  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Care Hospital ◽  
Elisa Method ◽  
Blood Samples ◽  
Awareness Campaigns ◽  
Hiv Test ◽  
Cd4 T Cell Count

Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in active age group (30.76%), housewives (28.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6 (5.7%). Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management.

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