Enteric parasitic infections in HIV-infected patients with low CD4 counts in Toto, Nigeria

Objectives: Enteric parasites are a major cause of diarrhoea in HIV/AIDS patients with low CD4 counts. Parasitic infections in HIV-infected individuals can reduce their quality of life and Life span, especially those who are severely immunosuppressed with a CD4 T-Lymphocyte count < 200cells/mu l. This study presents CD4 counts and enteric parasitic infections in HIV-infected individuals. Methodology: A total of 480 subjects were recruited at the General Hospital, Nasssarawa Toto, Nigeria. Stool samples collected were analyzed macroscopically and microscopically for consistency and the presence of enteric parasites; while the accompanying CD4 values were enumerated using the coulter manual CD4 count method. Results: The overall prevalence rate of enteroparasites was 24% (115/480). The parasites detected were Hookworm (6.5%), Entamoeba histolytica (4.4%), Schistosoma mansoni (2.9%), Giardia lamblia (2.5%), Entamoeba coli (2.3%), Isospora belli (1.7%), Strongyloides stercoralis (1.0%), Faciola spp. (1.0%), Dipylidium caninum (0.6%), Cyclospora spp. (0.4%), Ascaris lumbricoides (0.4%), and Enterobius vermicularis (0.2%). Most (80%) of the patients infected with these parasites had a CD4 count of less than 200 cells/mu l. Similarly, majority (65%) of patients with diarrhoea had a CD4 count of less than 200 cells/mu l. Patients with CD4 counts of 201 cells/mu l and above were less affected. However, these differences were not statistically significant (p>0.05). Conclusions: Low CD4 counts in HIV-infected patients can lead to enteric infections. This information strengthens the importance of monitoring CD4 counts and intestinal parasites. Routine CD4 testing will greatly improve the prognosis of HIV positive patients.