エイズと臨床研究のジャーナル

Background: Gastrointestinal infections in human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) patients are a significant cause of morbidity and mortality, affecting up to 90% patients with varied pattern of etiology across the globe.

Aim: The present study was conducted to determine the prevalence and microbiological profile of pathogens associated with diarrhea in HIV positive patients in Eastern India and their relation to CD4 counts.

Methods: This was a case-controlled study with consecutive HIV cases attending ART clinic from August 2014 to June 2017 with diarrhea taken as cases and one hundred age sex matched HIV negative population with diarrhea in the same period as controls. All patients were evaluated with stool routine and microscopic examination with all standard stains and transabdominal ultrasound. Patients with persistent diarrhea were subjected ileocolonoscopy with biopsy and culture for Mycobacterium tuberculosis. Statistical analysis was done by using SPSS software 16.

Results: A total of 226 subjects were enrolled (126 cases and 100 controls). Mean age nad male to female ratio of cases were 30.19 ± 7.127, 2.5:1 and that of controls were 28.32 ± 9.63, 1.8:1 respectively. The most common enteric pathogen detected in HIV positive diarrhea subjects was Mycobacterium tuberculosis [41 cases (32.53%)] followed by Isospora belli 21.49%) and Cryptosporidum parvum (11.9%). Among diarrheal stool samples with Mycobacterium tuberculosis, 73.3% cases had CD4 <200, 23.3% cases had CD4 200-350 and 3.33% case had CD4 >350 (p-value >0.05). All cases of Isosporiasis had CD4 <200 and 80% cases of Cryptosporidiosis had CD4 <200 and 20% had CD4 within 200-350. Correlation between Isospora&Cryptosporidiumwith CD4 count was significant (P<0.05).

Conclusion: Mycobacterium tuberculosis was the most commonly isolated pathogen in HIV associated diarrhea followed by Isosporaand Cryptosporidium.

Hepatitis B Virus (HBV) has been classified into genotypes A-J which characteristically has different geographic origins, disease progression and responses to antiviral treatment. Co-infection caused by Human immunodeficiency virus (HIV) and HBV is common because they both share similar routes of transmission. In this study, we report the prevalent HBV genotypes circulating among HBV-HIV co-infected patients in Port Harcourt, south-south Nigeria. DNA was extracted from stored serum samples obtained from 25 HBV-HIV co-infected patients selected out of 535 HIV I/II sero-positive patients confirmed to be HBsAg positive from University of Port Harcourt Teaching Hospital (UPTH) and Obio Cottage Hospital both in Port Harcourt City. HBV genotyping was carried out using a nested Polymerase Chain Reaction (PCR) approach followed by Big-dye termination sequencing. The mega blast search in the National Centre for Biotechnology Information (NCBI) database, revealed a close relatedness to HBV genotype B and E. Of the 25 samples, 15 (60.0%) were successfully genotyped. HBV genotype E was found in 10 (66.7%) of samples whereas, B was found in 5 (33.3%) participants. HBV genotypes B and E were found among HIV coinfected patients though genotype E was more predominant in this study. Early detection and identification of HBV genotype particularly in HIV co-infected patients could reduce the rate of liver degeneration and enhanced treatment.