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Parasitic infections in HIV infected individuals: diagnostic & therapeutic challenges

Veeranoot Nissapatorn1, Nongyao Sawangjaroen

  • 1Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. veeranoot@um.edu.my

The Indian Journal of Medical Research
|February 8, 2012
PubMed

Insights

Parasitic infections are common opportunistic infections in human immunodeficiency virus (HIV) patients, causing significant illness and death. This review covers the clinical, diagnostic, and therapeutic challenges of these parasitic infections in HIV-infected individuals.

Area of Science:

  • Medical Parasitology
  • Infectious Diseases
  • Immunology

Background:

  • Parasitic infections are frequent opportunistic infections (OIs) and major causes of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients.
  • Enteric parasitic pathogens cause diarrheal disease in immunocompromised individuals, with Cryptosporidium parvum and Isospora belli being common in acquired immunodeficiency syndrome (AIDS) patients.
  • Toxoplasmosis is a significant parasitic infection affecting the central nervous system in HIV patients, presenting in focal and disseminated forms and included in AIDS-defining illnesses.

Purpose of the Study:

  • To review the clinical, diagnostic, and therapeutic challenges of parasitic infections in HIV-infected patients.
  • To highlight the impact of parasitic infections as opportunistic infections in the context of the HIV epidemic.
  • To discuss the role of parasitic infections in immune reconstitution inflammatory syndrome (IRIS) following highly active anti-retroviral therapy (HAART).

Main Methods:

  • Literature review of parasitic infections in HIV/AIDS patients.
  • Analysis of clinical presentations, diagnostic methods, and treatment strategies.
  • Examination of the relationship between parasitic infections and immune status in HIV-infected individuals.

Main Results:

  • Cryptosporidium parvum and Isospora belli are key enteric protozoan OIs in AIDS patients.
  • Leishmaniasis, strongyloidiasis, and toxoplasmosis are major systemic parasitic infections in HIV patients, with toxoplasmosis being prominent in CNS involvement.
  • Several parasitic diseases, including cryptosporidiosis, leishmaniasis, and toxoplasmosis, are associated with IRIS in patients on HAART.

Conclusions:

  • Parasitic infections present complex clinical, diagnostic, and therapeutic challenges in HIV-infected individuals.
  • Effective management requires a thorough understanding of the specific parasite, host immune status, and potential for IRIS.
  • Continued research is needed to improve diagnostic accuracy and therapeutic outcomes for parasitic infections in the era of HAART.

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