Opportunistic Intestinal Protozoan Parasites among HIV Positive Patients on Antiretroviral Therapy at Nekemte Hospital, West Ethiopia

Abstract

Background and aim: Opportunistic protozoan infections are among the most serious infections in patients with AIDS. The aim of this study was to assess the impact of ART on opportunistic intestinal protozoan infections in HIV/AIDS patients.

Patients and Methods: HIV/AIDS patients that had not begun ART and those that were on-ART at Nekemte Hospital, West

Ethiopia were included. Stool specimens were collected from 296 HIV/AIDS patients (94 pre-ART and 202 on-ART) and processed using modified Ziehl-Neelsen staining for Cryptosporidium parvum and Isospora belli and Uvitex-2B staining method for microsporidia. CD4+ T-cell count was determined by using FACS analysis or flow cytometry.

Results: Out of the 296 study participants examined, 41 (13.9 %) and 14 (4.7 %) were positive for intestinal cryptosporidiosis and isosporiosis, respectively. Enterocytozoon bieneusi was detected in 7(4.8%) of the 145 participants examined. C. parvum

17(21.3%), I. belli 8(10%) and microsporidia 5(11.6%) were more common in pre-ART diarrhoeal patients than those on-ART.

The prevalence of cryptosporidiosis, isosporiosis and microsporidiosis among pre-ART study participants was significantly higher than those on-ART (P<0.05). A large majority of diarrhoeal AIDS patients infected with intestinal cryptosporidiosis and isosporiosis were in stage III of the WHO HIV/AIDS staging. An increase in CD4+ T-cell count was observed with increase in the number of months of ART.

Conclusion: The results of this study show that intervention with HAART decreases the prevalence of opportunistic intestinal protozoan parasites by improving the immune status of the patients and hence would enhance the health and well-being of HIV/

AIDS patients under the Ethiopian nutritional and health service system.