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Opportunistic Intestinal Parasites in HIV Infected Individuals and Its Correlation with the CD4 Counts.

Amol Zope, Anand Pai, Anuradha De, and Sujata M Baveja

The association between intestinal parasitic infections and human immunodeficiency virus (HIV) infection is well documented. These infections are often correlated with the CD4+T cell counts of the individuals. The prevalence of intestinal parasitic infections in HIV seropositive patients was compared with CD4 counts < 200 cells/μl, CD4 counts between 200- 500 cells/μl, and CD4 counts > 500 cells/μl. During one and a half years period, a total of 220 HIV seropositive patients were included in the study. One hundred and nineteen HIV seropositive patients were with CD4 counts < 200 cells/μl, 73 HIV seropositive patients were with CD4 counts between 200- 500 cells/μl and 28 HIV seropositive patients were with CD4 counts >500 cells/μl. The stool samples from these patients were examined for enteric parasites using saline and iodine mounts. Modified Z-N staining was carried out for enteric coccidian parasites and Modified trichrome stain for the microsporidia. The prevalence of intestinal parasites was 41.36%. Enteric parasitic infections with CD4 counts <200 cells/μl included Cryptosposidium spp 20.17%, Isopsora belli 6.72%, Entamoeba histolytica 5.88%, Giardia lamblia and Ascaris lumbricoides 4.20% each. The enteric parasites found with CD4 counts between 200-500 cells/μl included Cryptosposidium spp. 15.07% and E.histolytica 2.74%; and with CD4 counts >500 cells/μl included E.histolytica 10.71% and Cryptosposidium spp. 17.86%. Microsporidia were only present in those patients having CD4 counts <200 cells/μl. Continuous monitoring of CD4 counts in HIV seropositive patients is necessary to look for intestinal parasites in stool samples of these patients.