The Intestinal Parasitic Infections and the CD4 Counts in HIV Seropositive Individuals in the Dhule District in Maharashra, India

Context: Acquired Immunodeficiency Syndrome (AIDS) is fast becoming a major threat in the Indian subcontinent. Numerous opportunistic infections occur in such infected patients due to the downregulation of the immune system. Gastrointestinal parasitic infections are a universally recognized problem in these patients, reaching a rate of upto 50% in the developed and upto 95% in the developing countries. These infections largely present with diarrhoea, leading to life threatening complications. Aims: The present study was undertaken to determine the opportunistic parasitic infections in HIV AIDS patients and their correlation with the TCD4 count. Settings and Design: The present study was conducted in the Department of Microbiology, ACPM Medical College, Dhule, Maharashtra, India, a tertiary care hospital, between Dec 2010 to August 2011. The HIV infected patients who presented with diarrhoea were selected. Materials and Methods: The stool samples which were collected by taking universal precautions were examined by saline and iodine preparations and by the modified acid fast staining. The CD4 cell counts were estimated by using a FACS count system. Results: A total of 100 samples were received. Intestinal parasitic pathogens were detected in 55% of the patients. Among these 55 patients, coccidians were detected in 28 (50.9%) patients, protozoa in 15 (27.27%) patients, helminths in 12 (21.8%) patients, Cryptosporidium parvum in 15 (27.27%) patients, Isospora belli in 13 (23.63%) patients, Entamoeba histolytica in 9 (16.36%) patients, Giardia lamblia in 6 (10.9%) patients, Ascaris lumbricoides in 5 (9%) patients, Ancyclostoma duodenale in 3 (5.45%) patients, Hymenolepsis nana in 2 (3.6%) patients and Strongyloides stercoralis in 2 (3.6%) patients. Conclusion: Low CD4 counts were significantly associated with opportunistic infections. The detection of the aetiological pathogens might help the clinicians in deciding the appropriate management strategies, as an early diagnosis and a prompt treatment definitely contribute to an increased life expectancy by delaying the progression of AIDS.