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Published on: June 11, 2011
Molecular epidemiology of Cryptosporidium in HIV/AIDS patients in Malaysia
I Asma1, B L H Sim2, R D Brent3
1Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
Abstract:
Cryptosporidiosis is a particular concern in immunocompromised individuals where symptoms may be severe. The aim of this study was to examine the epidemiological and molecular characteristics of Cryptosporidium infections in HIV/AIDS patients in Malaysia in order to identify risk factors and facilitate control measures. A modified Ziehl-Neelsen acid fast staining method was used to test for the presence of Cryptosporidium oocysts in the stools of 346 HIV/AIDS patients in Malaysia. Standard coproscopical methods were used to identify infections with other protozoan or helminths parasites. To identify the species of Cryptosporidium, DNA was extracted and nested-PCR was used to amplify a portion of the SSU rRNA gene. A total of 43 (12.4%) HIV-infected patients were found to be infected with Cryptosporidium spp. Of the 43 Cryptosporidium-positive HIV patients, 10 (23.3%) also harboured other protozoa, and 15 (34.9%) had both protozoa and helminths. The highest rates of cryptosporidiosis were found in adult males of Malay background, intravenous drug users, and those with low CD4 T cell counts (i.e., < 200 cells/mm3). Most were asymptomatic and had concurrent opportunistic infections mainly with Mycobacterium tuberculosis. DNA sequence analysis of 32 Cryptosporidium isolates identified C. parvum (84.3%), C. hominis (6.3%), C. meleagridis (6.3%), and C. felis (3.1%). The results of the present study revealed a high prevalence of Cryptosporidium infection in hospitalized HIV/AIDS patients. The results also confirmed the potential significance of zoonotic transmission of C. parvum in HIV infected patients, as it was the predominant species found in this study. However, these patients were found to be susceptible to a wide range of Cryptosporidium species. Epidemiological and molecular characterization of Cryptosporidium isolates provides clinicians and researchers with further information regarding the origin of the infection, and may enhance treatment and control strategies.
Insights
Cryptosporidiosis is common in HIV/AIDS patients in Malaysia, with Cryptosporidium parvum being the most prevalent species. Risk factors include low CD4 counts, identifying potential zoonotic transmission routes for better control.
Area of Science:
- Medical Parasitology
- Infectious Diseases
- Molecular Epidemiology
Background:
- Cryptosporidiosis poses a significant health risk to immunocompromised individuals, particularly those with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS).
- Understanding the prevalence and species of Cryptosporidium in this vulnerable population is crucial for effective management and prevention strategies.
Purpose of the Study:
- To investigate the epidemiological and molecular characteristics of Cryptosporidium infections among HIV/AIDS patients in Malaysia.
- To identify risk factors associated with cryptosporidiosis in this cohort and to inform control measures.
Main Methods:
- Stool samples from 346 HIV/AIDS patients were analyzed using modified Ziehl-Neelsen acid fast staining.
- Conventional coproscopical methods were employed to detect other protozoan and helminth infections.
- Nested-PCR amplification of the SSU rRNA gene followed by DNA sequencing was used for Cryptosporidium species identification.
Main Results:
- A prevalence of 12.4% for Cryptosporidium infection was observed in the studied HIV/AIDS patients.
- Coinfections with other parasites were common, with 23.3% having other protozoa and 34.9% having both protozoa and helminths.
- Cryptosporidium parvum was the predominant species (84.3%), followed by C. hominis, C. meleagridis, and C. felis. Higher infection rates were noted in adult males of Malay background, intravenous drug users, and individuals with CD4 counts below 200 cells/mm³.
Conclusions:
- The study highlights a substantial prevalence of Cryptosporidium infection in hospitalized HIV/AIDS patients in Malaysia.
- The predominance of C. parvum suggests a significant role for zoonotic transmission in this population.
- Molecular and epidemiological data are vital for understanding infection origins and improving treatment and control strategies for cryptosporidiosis in HIV/AIDS patients.
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