Proportion of urinary schistosomiasis among HIV-infected subjects in Benin city, Nigeria

This study aimed to determine the prevalence of urinary schistosomiasis, and the effect of CD4+T cell counts and demographics on its prevalence among HIV-positive patients in Benin City, Nigeria. Urine and blood samples were collected from 2000 HIV-positive subjects. A wet preparation of the urine deposit was examined microscopically to identify ova of Schistosoma haematobium. The blood specimens were analyzed using the flow cytometry for CD4+T-lymphocyte count. An overall prevalence rate of 0.3% was reported. Gender and CD4 count<200 cells/micro L did not affect the prevalence of urinary schistosomiasis, while HIV patients that were single had significantly higher prevalence of urinary schistosomiasis [p=0.002]. The prevalence of urinary schistosomiasis among HIV patients in Benin City is low. CD4+count did not affect the prevalence of urinary schistosomiasis

Molecular characterization of Cryptosporidium spp. from HIV infected patients from an urban area of Brazil / Caracterização molecular de Cryptosporidium spp. de pacientes de área urbana do Brasil infectados por HIV

Cryptosporidium spp. are important cause of enteric disease in humans, but may also infect animals. This study describes the relative frequency of several Cryptosporidium species found in human specimens from HIV infected patients in the São Paulo municipality obtained from January to July 2007. Sequence analysis of the products of nested-PCR based on small subunit rRNA and Cryptosporidium oocyst wall protein coding genes revealed 17 (63.0 percent) isolates of C. hominis, four (14.8 percent) C. parvum, five (18.5 percent) C. felis and one (3.7 percent) C. canis. These findings suggest that, in urban environments of Brazil, the cat adapted C. felis may play a potential role in the zoonotic transmission of cryptosporidiosis whereas the anthroponotic transmission of cryptosporidiosis caused by C. hominis seems to predominate.

Cryptosporidium spp. são importantes causas de doenças entéricas em humanos, mas podem também ser encontrados em animais. O presente estudo descreve a frequência relativa de diversas espécies de Cryptosporidium em amostras de humanos da cidade de São Paulo, Brasil, obtidas de janeiro a julho de 2007. Análises de sequências de produtos de nested PCR direcionadas ao genes codificadores da menor unidade ribosomal e da proteina de parede de oocistos revelaram 17 (63,0 por cento) isolados de C. hominis, quatro (14,8 por cento) C. parvum, cinco (18,5 por cento) C. felis, e um (3,7 por cento) C. canis. Estes resultados sugerem que, em ambientes urbanos no Brasil, o genótipo adaptado ao gato pode desempenhar potencial papel na transmissão zoonótica de criptosporidiose, enquanto a transmissão antroponótica da criptosporidiose causada pelo C. hominis parece predominar.

Opportunistic parasitic infections in HIV/AIDS patients presenting with diarrhoea by the level of immunesuppression.

Background & objectives: Enteric parasites are major cause of diarrhoea in HIV infected individuals. The present study was undertaken to detect enteric parasites in HIV infected patients with diarrhoea at different levels of immunity. Methods: The study was carried out at National AIDS Research Institute, Pune, India, between March 2002 and March 2007 among consecutively enrolled 137 HIV infected patients presenting with diarrhoea. Stool samples were collected and examined for enteric parasites by microscopy and special staining methods. CD4 cell counts were estimated using the FACS count system. Results: Intestinal parasitic pathogens were detected in 35 per cent patients, and the major pathogens included Cryptosporidium parvum (12%) the most common followed by Isospora belli (8%), Entamoeba histolytica/Enatmoeba dispar (7%), Microsporidia (1%) and Cyclospora (0.7%). In HIV infected patients with CD4 count < 200 cells/μl, C. parvum was the most commonly observed (54%) pathogen. Proportion of opportunistic pathogens in patients with CD4 count <200 cells/μl was significantly higher as compared with other two groups of patients with CD4 count >200-499 and ≥ 500 cells/μl (P=0.001, P=0.016) respectively. Interpretation & conclusions: Parasitic infections were detected in 35 per cent HIV infected patients and low CD4 count was significantly associated with opportunistic infection. Detection of aetiologic pathogens might help clinicians decide appropriate management strategies.

Detection of Cryptosporidium parvum in HIV-infected patients in Malaysia using a molecular approach.

This cross-sectional study determined the prevalence of cryptosporidiosis in HIV-infected patients using polymerase chain reaction (PCR). Stool specimens were collected from HIV infected patients who were admitted to Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia, for various indications from December 2004 to December 2005. A modified acid-fast stain was performed on the direct stool smears, then the stool specimens were further tested using nested PCR targeting the 18S rRNA gene of Cryptosporidium parvum, with a built-in internal control (IC). Out of 59 samples, 11 were positives. Nested PCR identified a total of nine samples (16%) compared to microscopy, which identified only three samples. All PCR negative results showed IC amplicons, suggesting that these samples were true negatives and were not due to inhibition of PCR. This study highlights the importance of molecular diagnosis in determining the true prevalence and epidemiology of C. parvum.

frequency of toxoplasma and cytomegalovirus infections in HIV-positive patients in HIV/AIDS counseling and care center in Kurdistan in 1385

Cytomegalovirus [CMV] and toxoplasmosis are the most common and serious opportunistic infections in AIDS patients. Despite recent advances in the treatment of these infections, they still remain as challenging problems for physicians. The aim of this study was to determine the frequency of cytomegalovirus and toxoplasma infections in HIV-positive patients in HIV/AIDS counseling and care center in Kurdistan in 1385. This was a cross-sectional descriptive, analytic study. The sample size included all accessible patients referring to Sanandaj behavioral and STD diseases consultation center [64 participants]. ELISA test was performed for all individuals, IgM and IgG anti CMV and Toxoplasma titers were determined. Data were introduced into SPSS 13 Soft ware and analyzed by one way ANOVA test. This study included 64 patients, 98/4% of them were male. The mean age of the patients was 32.1 +/- 6.73 years. Anti cytomegalovirus IgM was negative and anti cytomegalovirus IgG was positive in all of the patients [100%]. Anti Toxoplasma IgM and anti Toxoplasma IgG were positive in 10.9% and 46.9% of the patients respectively. There was no significant relationship between the level of IgG and mean time duration of being HIV positive, age and CD4 cell count. But a significant relationship was noticed between the level of CMV and toxoplasma IgM and CD4 cell count [p<0.05]. There was a significant relation between positive toxoplasmosis IgM and history of keeping a pet in house [p=0.019]. In this study 100% of HIV positive participants were negative for anti cytomegalovirus IgM which can be explained by presence of CD4 cell count above 100 in all of the patients. But 53% of HIV positive participants had negative anti toxoplasma antibody who will be at risk of acute toxoplasmosis in their clinical course. Educational plans and regular follow up of these patients are recommended for proper prophylaxis and treatment

Toxoplasmosis in HIV/AIDS patients in Shiraz, southern Iran

Toxoplasma gondii is an intracellular protozoan parasite, and causes zoonotic infection. Human latent toxoplasmosis occurs in about half the world's population though most cases are asymptomatic. Toxoplasma encephalitis [TE] has become one of the more frequent opportunistic infection in HIV infected patients. This retrospective and descriptive study was carried out at the Referral Behavioral Counseling and Modification Center in Shiraz, Iran. We were able to review the medical records of 208 HIV infected patients. They were examined and their records were screened via the standardized data collection sheet for demographic characteristics. Diagnoses of TE based on the presence of at least two of the following findings: a history of neurological symptoms, neurological signs, suggestive CT, clinical and radiological response to antitoxoplasmosis medication. The seroprevalence of toxoplasmosis among 208 HIV/AIDS patients was [18.2%] [38 patients] while 4 [10.4%] and 34 [89.6%] subjects showed Toxoplasma seropositivity with and without TE respectively. The majority of these patients were in the 25-34 age group, male, unemployed, single and residence in Shiraz, southern Iran. Toxoplasmosis is a silent disease, which poses many diagnostic and therapeutic challenges. Based on findings of this study, we support a screening program of Toxoplasma infection. Primary chemoprophylaxis should be routinely given to all HIV infected with Toxoplasma seropositive status. Also HIV infected individuals with Toxoplasma seronegative status may be advised about preventive behavioral practice

Identification of Leishmania chagasi from skin in Leishmania/HIV co-infection: a case report

A case of HIV/Leishmania co-infection presenting both visceral and cutaneous manifestations is reported. Leishmania infection was confirmed by conventional methods (parasitological approach and serology) and by PCR. Leishmania chagasi isolated from the skin lesion was characterized by enzyme electrophoresis and by restriction fragment length polymorphism of the internal transcribed spacer of the ribosomal gene.

Anticuerpos contra Toxoplasma gondii en pacientes con VIH en Yucatán / Antibodies against Toxoplasma gondii in patients with VIH in Yucatan

Objetivo. Conocer la prevalancia de anticuerpos contra T. gondii tipo IgG (Ac-T gondii) en pacientes con VIH residentes de la península de Yucatán. Métodos. Fueron 95 pacientes con VIH y 100 donadores de sangre como grupo control. Se midieron los Ac-T gondii por un ELISA de fase sólida de 3ª generación. Se recolectaron datos clínicos demográficos. Resultados. Hubo mayor frecuencia (p= 0.003) de anticuerpos en donadores (69 por ciento, IC = 59-78 por ciento) que en pacientes (47 por ciento, IC = 36-57 por ciento). No se asoció la presencia de Ac-T gondii con alguna de las variables encuestadas (género, lugar de residencia, grupo etario). En los pacientes con VIH/SIDA no hubo relación de anticuerpos con cuenta de linfocitos CD4 ni con categoría clínica de la infección. Conclusiones. la alta prevalencia de Ac-T gondii en ambos grupos sugiere que esta zoonosis es endémica en la península de Yucatán, lo cual justifica la determinación rutinaria de Ac-T gondii y protocolos terapéuticos en los pacientes con VIH/SIDA ya que un porcentaje alto de ellos estaría en riesgo de desarrollar toxoplasmosis encefálica

Cryptosporidium and HIV.

To study the importance of cryptosporidium as a diarrhoea causing pathogen (using stool samples), a cohort study was conducted from 14-9-1994 to 14-3-1995 on injecting drug users in Imphal. Stool samples were also collected from close contacts of the patients of human immunodeficiency virus (HIV) infected cryptosporidium diarrhoea cases and patients of paediatric medicine ward of Regional Institute of Medical Sciences (RIMS), Imphal. A total of 9 cases of cryptosporidium diagnosed out of 11 HIV infected diarrhoea cases and 2 out of 11 personal contacts were found to be positive. Two cases with history of close contacts with HIV infected cryptosporidium diarrhoea cases were not suffering from diarrhoea. One out of 7 paediatric diarrhoea cases was found to be positive. Five out of 9 HIV infected cryptosporidial cases died within one month of diagnosis of cryptosporidium. The remaining 4 had improved and diarrhoea was controlled. One of the 4 did not show cryptosporidium any more in the stool sample.

Microsporidiosis en pacientes con diarrea crónica y sida, hiv asintomáticos y pacientes con diarrea aguda / Microsporidiosis in patients with chronic diarrhea and aids, asymptomatic hiv and patients with acute diarrhea

Microsporidia are intracellular protozoa that mainly affect AIDS patients and chronic diarrhea, caused by the strains Enterocytozoon bieneusi and septata intestinalis, is the most common clinical manifestation. The diagnosis is made in intestinal biopsies, however the recently developed trichomic stain with chromotrope 2R, is able to detect microsporidia in stools and has a good correlation with the biopsy. Using this technique, we studied 43 asymptomatic HIV infected subjects, 89 AIDS patients with chronic diarrhea and 186 patients with acute diarrhea as controls. Thirty three percent of patients with AIDS, 16.3 percent of HIV infected subjects and none of the individuals with acute diarrhea had microsporidia in their stools (p<0.05). In 15 patients with AIDS we detected intermitted stool microsporidia shedding; this finding should encourage repetitive examinations in negative cases. The trichomic stain for microsporidia is proposed as a routine test in AIDS patients with diarrhea

Presentación de dos casos y revisión de la literatura: nocardiosis asociada a inmunosupresión / Report of two cases and review of literature: nocardiosis associated with immunosuppression

Se presentan dos casos de infección por Nocardia asteroides identificados en el Hospital Vargas de Caracas en 1991. Ambos presentan estados de inmunosupresión caracterizados, en el primero por uso prolongado de esteroides y el segundo por infección por VIH. Los sitios de infección por Nocardia incluyeron: pulmón y ganglios linfáticos. Fueron tratados con sulfonamida y TMP-SMX respectivamente, falleciendo uno de ellos por retardo en la identificación bacteriana. Se revisa la literatura referente a infección por Nocardia sp. Debido al incremento en la incidencia de estados de inmunosupresión, adquiridos como en el SIDA o inducidos por drogas (esteroides y antineoplásicos) se está presentando un aumento notable de infecciones oportunistas que obliga a los médicos a mantener un alto índice de sospecha para el diagnóstico precoz y manejo terapético.