Cryptosporidium species in HIV patients in Alexandria, Egypt: distribution and associated clinical findings
https://doi.org/10.47665/tb.39.1.013
- Author:
Mohamed, M.A.
1
;
Hammam, H.M.
1
;
El-Taweel, H.A.
1
;
Abd El-latif, N.F.
1
Author Information
1. Parasitology Department, Medical Research Institute, Alexandria University, Egypt 165 El-Horreya Avenue, El-Hadara, Alexandria, Egypt
- Publication Type:Journal Article
- Keywords:
Cryptosporidium;
HIV;
CD4+;
RFLP;
sequencing.
- From:Tropical Biomedicine
2022;39(No.1):108-116
- CountryMalaysia
- Language:English
-
Abstract:
Cryptosporidium sp. cause opportunistic infections in HIV patients. Molecular differentiation
provides a better understanding of the epidemiology and clinical variations of cryptosporidiosis.
The present work studied the species of Cryptosporidium in HIV patients and their associated
demographic and clinical features. The study included 100 adult HIV patients receiving
antiretroviral therapy in Egypt. Cryptosporidium infection was diagnosed by modified ZiehlNeelsen (MZN) stain and PCR amplification of COWP gene. The infecting species were
molecularly identified by restriction fragment length polymorphism (RFLP) and DNA
sequencing. Data were analyzed using Kappa (K) agreement, Mann–Whitney U, odds ratio
and the 95% confidence interval, Chi-squared and Monte Carlo significance (MCp) tests. The
statistical significance was judged at the 5% level. A total of 16 Cryptosporidium positive
cases were detected (16%), with good agreement between PCR and MZN (K = 0.763). Among 11
PCR positive samples, RFLP identified C. hominis in five samples, C. parvum in three samples,
C. meleagridis in two samples, and mixed C. hominis and C. meleagridis in one sample. Eight
samples were successfully sequenced and the results confirmed the RFLP classification.
C. hominis was found mainly in urban residents while C. parvum and C. meleagridis were
significantly associated with rural areas (MCp =0.01). Diarrhoea and nausea/vomiting were
recorded only in the presence of C. hominis infection while abdominal pain was the main
symptom in C. parvum and C. meleagridis infections. Drinking water sources, contact with
animals, and CD4+ count were not related to infection with a particular species. In conclusion,
infection with Cryptosporidium sp. is common and frequently symptomatic in HIV patients in
Egypt. The predominant species, C. hominis, C. parvum, and C. meleagridis show a distinct
distribution in urban and rural residents.
- Full text:8.2022my1320.pdf
