Enteric parasitic infection among HIV-infected patients visiting Tribhuvan University Teaching Hospital, Nepal.
BACKGROUND
Enteric parasitic infection among human immunodeficiency virus (HIV) patients has been a significant health problem in developing countries like Nepal. This study was undertaken to access the burden of enteric parasites among HIV patients and its association with their immune status.


METHODS
A cross-sectional study, involving 112 HIV sero-positive patients was conducted in Tribhuvan University Teaching Hospital, Public Health Research Laboratory, Kathmandu, Nepal from July 2011 to June 2012. The fecal samples were processed by direct-smear technique, in both normal saline solution and 1% iodine solution as well as modified acid fast staining (Kinyoun's method) after formalin ether concentration and Sheather's sucrose flotation for the identification of enteric parasites.


RESULTS
Infection with one or more parasite was seen in 33.9% (n = 38) of the cases enrolled in the study, with the parasite prevalence rate of 41.1% (n = 46). Literacy (OR = 1.9, 95% CI 0.9-4.3) and CD4 T-cell count <200 (OR = 2.5, 95% CI 1.1-5.7) were found to be associated with enteric parasite infection. Similarly, CD4 T-cell count <200 was found to be associated with opportunistic parasitic infection (OR = 3.2, 95% CI 1.2-7.8). Among opportunistic parasites, Giardia duodenalis was the most common (28.3%, n = 13) one. Multi-parasitism was observed in six patients (15.8%).


CONCLUSION
Enteric parasitic infections are common in HIV-infected people. The poor immune status as indicated by low CD4 T-cell count may account for higher risk of both opportunistic and non-opportunistic enteric parasitic infection.
['Ghimire|Ananda|A|', 'Bhandari|Shiva|S|', 'Tandukar|Sarmila|S|', 'Amatya|Jyoti|J|', 'Bhandari|Dinesh|D|', 'Sherchand|Jeevan Bahadur|JB|']
D017088:AIDS-Related Opportunistic Infections D000293:Adolescent D000328:Adult D000818:Animals D016845:Blastocystis hominis D018791:CD4 Lymphocyte Count D015496:CD4-Positive T-Lymphocytes D015897:Comorbidity D003430:Cross-Sectional Studies D004748:Entamoeba histolytica D005243:Feces D005260:Female D016829:Giardia lamblia D015658:HIV Infections D006784:Hospitals, Teaching D006785:Hospitals, University D006790:Host-Parasite Interactions D006801:Humans D007411:Intestinal Diseases, Parasitic D008297:Male D008875:Middle Aged D009390:Nepal D010271:Parasites D055815:Young Adult
Enteric parasites HIV CD4 T-cell Multi-parasitism Diarrhea