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

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.

2015 ◽  
Vol 3 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Desh D Singh ◽  
Vinod Singh

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 


2019 ◽  
Vol 66 (2) ◽  
pp. 178-186
Author(s):  
William Baiye Abange ◽  
Celine Nguefeu Nkenfou ◽  
Hortense Gonsu Kamga ◽  
Clement Assob Nguedia ◽  
Nelly Kamgaing ◽  
...  

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 &gt;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.


Author(s):  
Mandisa Skhosana ◽  
Shabashini Reddy ◽  
Tarylee Reddy ◽  
Siphelele Ntoyanto ◽  
Elizabeth Spooner ◽  
...  

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


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4060-4060
Author(s):  
Simon Turcotte ◽  
Yannic McNicoll ◽  
Genevieve Soucy ◽  
Louis Gaboury ◽  
Real W. Lapointe ◽  
...  

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.


2018 ◽  
Vol 16 (3) ◽  
pp. 325-329
Author(s):  
Sapana Karn ◽  
Manjula Bhattarai ◽  
Ramanuj Rauniyar ◽  
Anurag Adhikari ◽  
Pratik Karna ◽  
...  

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.


2018 ◽  
Vol 5 (3) ◽  
pp. 566
Author(s):  
P. K. Bariha ◽  
M. K. Mohapatra ◽  
B. K. Kullu ◽  
P. C. Karua ◽  
S. B. Biswal ◽  
...  

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.


2018 ◽  
Vol 16 (3) ◽  
pp. 325-329
Author(s):  
Sapana Karn ◽  
Manjula Bhattarai ◽  
Ramanuj Rauniyar ◽  
Anurag Adhikari ◽  
Pratik Karna ◽  
...  

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 and 95% 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.


2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Shimelis Assefa ◽  
Berhanu Erko ◽  
Girmay Medhin ◽  
Zelalem Assefa ◽  
Techalew Shimelis

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