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首页> 外文期刊>International Journal of General Medicine >Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients
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Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

机译：HIV / AIDS患者中小孢子虫病和隐孢子虫病的流行病学，临床，免疫和分子特征

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Background: The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients.Methods: In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk.Results: Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of <100 cells/mm3, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of <100 cells/mm3, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of <100 cells/mm3 (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P < 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites.Conclusion: E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human infection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.
机译：背景：本研究的目的是确定肠道寄生虫的患病率，特别侧重于小孢子虫和隐孢子虫，以及它们与人类免疫缺陷病毒（HIV）症状，危险因素和其他消化道寄生虫的关系。我们还希望确定HIV感染者中小孢子虫和隐孢子虫的种类和基因型的分子生物学定义。方法：在这项横断面研究中，在刚果民主共和国金沙萨进行了大便样本采集，其中包括242名HIV患者（87名男性和155名女性）具有机会性肠道寄生虫的相关症状和危险因素。使用Ziehl–Neelsen染色，实时聚合酶链反应（PCR），免疫荧光间接单克隆抗体，嵌套式PCR限制性片段长度多态性以及PCR扩增和测序对粪便标本进行分析。结果：在242名HIV患者中，分别有7.8％，0.4％，5.4％，0.4％，2％，10.6％和2.8％的肠小肠肠杆菌，肠道脑虫，隐孢子虫，贝氏孢子虫，致病性肠原生动物，非致病性肠原生动物和蠕虫。我们发现了大肠埃希氏菌的五个基因型：两个较老的NIA1和D，以及三个新的KIN1，KIN2和KIN3。分别只有0.4％和1.6％的小隐孢子虫和人隐孢子虫。在这些患者中，分别有36.4％，34.3％，31％和39％的患者患有乏力，腹泻，CD4计数<100个细胞/ mm3，并且没有抗逆转录病毒疗法（ART）。大多数患有机会性肠道寄生虫和人形衣原体的人，以及所有患有小肠衣原体和新的比氏肠杆菌基因型的人，腹泻，CD4 +计数低于100细胞/ mm3且没有ART。肠杆菌，卡波西肉瘤，带状疱疹，慢性腹泻和乏力之间存在显着相关性，并且存在28例机会性肠道寄生虫。农村地区，公共厕所和猪场暴露是28例机会性肠道寄生虫病例中的单因素风险因素。在逻辑回归分析中，CD4计数小于100个/ mm3（OR = 4.60; 95％CI 1.70–12.20; P = 0.002），无ART（OR = 5.00; 95％CI 1.90–13.20; P <0.001），暴露于地表水（OR = 2.90; 95％CI 1.01–8.40; P = 0.048）被认为是机会性肠道寄生虫的重要和独立的决定因素。 ，刚果。根据调查结果，我们建议通过卫生，敏感的PCR方法的重点进行流行病学监测和预防，并治疗可能通过粪便，口水传播，地表水，正常免疫力，基于农村地区的人来获得的机会性肠道寄生虫。人和动物-人的感染以及艾滋病毒的传播。需要包括ART在内的治疗和烟曲霉素的治疗。

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