Prevalence of Intestinal Parasitic Infestation and the Related Profile of the CD4+ Counts in HIV/AIDS People with Diarrhoea in Jaipur City

Introduction: Gastrointestinal Tract (GIT) infections are among the most frequent infections in HIV/AIDS patients. The intestinal opportunistic parasitic infections in HIV-infected subjects present most commonly as diarrhoea. A study was conducted to determine the prevalence of enteric parasitic infections in HIV infected patients with diarrhoea, with different levels of immunity. Methods: This study was carried out at the HIV Lab of the Microbiology Department of a tertiary care teaching hospital in Jaipur, Rajasthan, between June-October 2009 among consecutively enrolled 75 HIV infected patients who presented with diarrhoea. Stool samples were collected and examined for enteric parasites by using microscopy and special staining methods. The CD4+ cell counts were estimated by using the FACS count system. Results: Intestinal parasitic pathogens were detected in 38.66% patients, Cryptosporidium species was the most common enteric opportunistic parasite which accounted for 37.93 % of the total parasites, followed by Isospora belli 31.03 %. In the HIV infected patients with CD4+ counts of < 200 cells/mu l, parasites were identified in 56.25 % patients and in HIV patients with CD4+ counts between 200-499 cells /mu l, parasites could be identified in 27.5 % of the patients. No parasite was detected in the patients with CD4+ counts of > 500 cells/ mu l. Conclusion: Parasitic infections were detected in 38.66% HIV infected patients with diarrhoea and a low CD4+ count was significantly associated with opportunistic infections. Identification of the aetiological agent of diarrhoea in an HIV patient is very important, as it can help in the institution of the appropriate therapy and the reduction of the morbidity and the mortality in these patients.