Enteric parasitosis and its correlation with CD4 count in human immunodeficiency virus infected patients

Background: The gastrointestinal tract of the HIV/AIDS patient (s) is harboured by a number of luminal extracellular and intracellular parasites. These parasites are responsible for deteriorating and worsening the general health condition(s) of these immunocompromised groups of patients. Moreover, these parasitic infections are often correlated with the CD4 counts of the individuals. Therefore, with a view to assess the relationship between the presence of parasitic infection and that of the CD4 count, the present work is being undertaken.Methods: The study was conducted in the Parasitology section of the department of Life Sciences, Manipur University and CD4 count unit of Microbiology Department, RIMS hospital Imphal from 34 HIV positive Antiretroviral treatment (ART) naive patients, aged between 19 to 50 years. The samples were taken from the patients only after obtaining a signed consent form . Techniques like normal saline method, iodine wet preparation method, formol ethyl acetate concentration technique, Baermann modified funnel technique, modified Ziehl Neelsen staining technique and adhesive cellophane tape method were employed for the present investigation.Results: The present study reveals that patients with CD4 count <200 cells/μl were harbouring only two parasites (Cryptosporidium sp and G. lamblia) whereas individuals with CD4 count within the range of 200-500 cells/μl were observed to have harboured G. lamblia, Cryptosporidium sp, E.histolytica, hookworm, S. stercoralis and A. lumbricoides. On the other hand, enteric parasites associated with CD4 count >500 cells/μl included G. lamblia, hookworm, E. vermicularis and S. stercoralis.Conclusions: The present study shows that occurrence of intestinal parasitism is independent of CD4 count in HIV infected patients. Therefore, based on the present findings, it may be suggested that irrespective of CD4 count(s) and whether the patient experiences diarrhoea or not, regular monitoring of the HIV patient(s) for the presence of enteric parasitosis by adopting standard laboratory protocols should be encouraged for maintaining a healthy life of the people living with HIV/AIDS.