Intestinal parasitic infections: prevalences in HIV/AIDS patients in a Thai AIDS-care centre

Abstract

During 2005, the intestinal parasitic infections in the adult HIV/AIDS patients in a combined AIDS-care centre and hospice in Thailand were identified in a cross-sectional study. Overall, 41 (45.6%) of the 90 stool samples investigated, by microscopy and/or PCR, were found parasite-positive. Cryptosporidium was the genus most commonly encountered, with 27 (30.0%) of the patients positive for Cr. hominis and four (4.4%) positive for Cr. meleagridis. Enterocytozoon bieneusi, always of genotype D, was detected in five (5.6%) of the patients while two patients (2.2%) were found infected with Blastocystis, just one patient (1.1%) was found infected with Cyclospora cayetanensis and one more (1.1%) was found positive for Isospora belli. The only helminth infection detected was opisthorchiosis and that was only seen in two (2.2%) of the subjects.

Patients with stools of unusual consistency (categorized as mucous, loose–watery or watery) were more likely to be found infected with one or more species of protozoan parasite than the patients with stools of normal consistency (P=0.022). In a multivariate analysis, compared with the other subjects, the patients with stools of unusual consistency were 4.9-fold more likely to have (opportunistic) intestinal infection with parasitic protozoa (with a 95% confidence interval for the adjusted odds ratio of 1.370–17.350; P=0.014). Although there was also a trend for stools of unusual colour (red–brown, red–orange, green, black or grey) to be positively associated with intestinal parasitic infection, this was not statistically significant (P=0.658). The observation of the consistency of stools of HIV/AIDS patients could help in the presumptive diagnosis of opportunistic protozoan infections and allow parasitological investigation to be targeted at the cases most likely to be found positive.