Prevalence of Cryptosporidium and microsporidial infection in HIV-infected individuals.

BACKGROUND: Microsporidia and Cryptosporidium are obligate intracellular protozoa. These medically important species are recognized as opportunistic organisms in intestinal complications in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome patients. METHODS: The current cross-sectional study was designed and conducted from August 2016 to August 2017 to determine intestinal Cryptosporidium and microsporidia spp. in HIV-infected individuals from the Behavioral Diseases Counseling Center, Tabriz, Iran, by modified acid-fast and modified trichrome staining and nested polymerase chain reaction (PCR) and real-time PCR. RESULTS: Of 100 HIV-infected persons, 21.0% (95% confidence interval [CI] 13.0 to 30.0) and 18.0% (95% CI 11.0 to 26.0) were identified as Cryptosporidium and microsporidia, respectively, by the microscopic method. Of these 100 HIV-infected persons, 18.0% (95% CI 11.0 to 26.0) and 14.0% (95% CI 7.0 to 22.0) were positive for Cryptosporidium and microsporidia, respectively, by the molecular method. The predominant species of microsporidia in patients was Enterocytozoon bieneusi (85.7% [95% CI 57.0 to 98.0]) and Encephalitozoon cuniculi (14.3% [95% CI 1.7 to 42.0]), which were found by quantitative real-time PCR and its high-resolution melting tool. CONCLUSIONS: As far as we know, this study is the first to estimate the prevalence of infection with Cryptosporidium and microsporidia among HIV-infected persons in northwest of Iran. The prevalence of intestinal microsporidiosis and cryptosporidiosis in this area in HIV-infected people was higher than the global prevalence of infection among immunocompromised patients. In addition to the need for further studies to prove protozoan pathogenicity in the aforementioned group, preventive measures should be considered.

Sero-molecular evaluation of Toxoplasma gondii infection among HIV-positive patients.

BACKGROUND: Toxoplasmosis is one of the most common comorbidities in HIV-positive patients with CD4+ T lymphocytes below 200 cells/µl. Early diagnosis and treatment of toxoplasmosis reduces the mortality rate in HIV-positive people. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in HIV-positive patients in northwest Iran using serological and molecular methods. METHODS: This prospective cross-sectional study included 124 HIV-positive outpatients and was conducted from January to May 2016. Anti-T. gondii IgM and IgG antibodies were detected from sera samples by chemiluminescence, while buffy coat samples were analyzed by RT-PCR for DNA detection. Patients' socioepidemiological data were collected. RESULTS: Using chemiluminescence, 47/124 samples (37.9%) were positive for anti-Toxoplasma IgG antibodies, 2/124 samples (1.62%) were positive for IgM antibodies while 2/124 samples (1.62%) contained both IgM and IgG. There were no IgM-positive or IgG-negative patients. RT-PCR revealed four (3.22%) positive samples. On the basis of the results, a statistically significant relationship was found between anti-Toxoplasma IgG antibody seropositivity and residence (p=0.012). CONCLUSIONS: The study showed a relatively low seroprevalence of anti-T. gondii IgG and IgM antibodies in HIV-positive patients in northwest Iran, while the prevalence was much higher in other regions of Iran. However, regular screening for T. gondii antibodies and early initiation of therapy are very important to decrease the mortality rate in HIV-positive patients.