Seroprevalence of Entamoeba histolytica in the context of HIV and AIDS: the case of Vhembe district, in South Africa's Limpopo province

In a recent study in northern South Africa, the seroprevalence of Entamoeba histolytica infection among 257 HIV-positive and 117 HIV-negative individuals was determined, using an ELISA for the detection of antibodies reacting with the parasite's galactose/-acetyl-D-galactosamine(Gal/GalNAc)-inhibitable adherence lectin. Overall, 34.0% of the 374 participants (36.1% of the females and 28.1% of the males) were found seropositive for E. histolytica. Although all age-groups were affected by the amoebic pathogen, the subjects aged 50-59 years had the highest seroprevalence (69.2%). The seroprevalence of E. histolytica was also significantly higher among the HIV-positive subjects than among the HIV-negative (42.8% v. 14.5%; chi(2) = 28.65; P < 0.0001). Among the HIV-positive subjects, those with fewer than 200 CD4+ cells/mu l were relatively more likely to be seropositive for E. histolytica (60.3% v. 43.8%; chi(2) = 4.016; P = 0.045). This is the first report indicating a positive association between E. histolytica infection and HIV in South Africa. Further studies, for example to determine the occurrence of diarrhoea or liver abscess in the study area, in relation to seropositivity for E. histolytica and/or HIV, are now needed.