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How common is intestinal parasitism in HIV-infected patients in Malaysia?

I Asma1, S Johari, Benedict L H Sim

  • 1Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur.

Tropical Biomedicine
|November 2, 2011
PubMed

Insights

Intestinal parasitic infections (IPIs) affect 37.9% of HIV-infected individuals in Malaysia, with protozoa more common than helminths. Low CD4 counts and specific risk factors are associated with these infections.

Area of Science:

  • Medical Parasitology
  • Infectious Diseases
  • Public Health

Background:

  • Human immunodeficiency virus (HIV) infection compromises the immune system, increasing susceptibility to opportunistic infections.
  • Intestinal parasitic infections (IPIs) are often overlooked in HIV-infected individuals, despite their potential for significant morbidity and mortality.
  • Limited data exists on the prevalence and epidemiology of IPIs in HIV-infected populations, particularly in Malaysia.

Purpose of the Study:

  • To determine the prevalence of intestinal parasitic infections (IPIs) among HIV-infected individuals in Malaysia.
  • To identify common protozoa and helminth species causing IPIs in this population.
  • To explore associations between IPIs and clinical factors such as CD4 T cell counts, risk behaviors, and antiretroviral therapy status.

Main Methods:

  • A cross-sectional study was conducted involving 346 HIV-infected individuals in Malaysia.
  • Stool samples were examined to detect and identify intestinal protozoa and helminths.
  • Data on CD4 counts, antiretroviral therapy (ART) status, drug use, and concurrent opportunistic infections (OIs) were collected and analyzed.

Main Results:

  • The overall prevalence of IPIs was 37.9%, with protozoa (18.8%) more prevalent than helminths (7.5%).
  • Common protozoa included Entamoeba histolytica/dispar and Cryptosporidium parvum; common helminths included Ascaris lumbricoides.
  • Infected individuals had significantly lower CD4 counts (<200 cells/mm³), and many were intravenous drug users or not on ART. Concurrent opportunistic infections, notably Mycobacterium tuberculosis, were frequent.

Conclusions:

  • Intestinal parasitic infections are common in HIV-infected individuals in Malaysia, especially those with low CD4 counts.
  • Routine screening for IPIs is recommended for effective management of gastrointestinal symptoms and opportunistic infections in HIV patients.
  • Understanding the epidemiology of IPIs in this vulnerable population is crucial for targeted prevention and treatment strategies.

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