A Comprehensive Study On Cryptosporidiosis In Hiv/Aids Patients In Raichur District, Karnataka

Abstract

Cryptosporidium parvum is one of the most important enteric opportunistic parasitic infections in immunocompromised patients. Cryptosporidium parvum is a coccidian protozoal parasite that inhabits the brush border of enterocytes, damages the epithelial cells and causes diarrhoeal disease. It causes severe and prolonged diarrhoea in HIV sero-positive/AIDS patients with CD4counts <200 cells/cumm. Early detection of cryptosporidium will enable the clinician in effective management of the disease. Various techniques based on different principles are available for the diagnosis of cryptosporidiosis. There is a need to evaluate these methods for optimal benefit of the patients. There is a high incidence of HIV infection/AIDS in Raichur District, Karnataka. Hence it is pertinent to study the incidence of the opportunistic parasitic diseases like cryptosporidial infection in these individuals. This cross sectional descriptive study was undertaken with the following aims and objectives. Aims and Objectives This study was aimed to determine the incidence of cryptosporidial infection in HIV sero- positive/AIDS patients both with diarrhoea as well as without diarrhoea, to evaluate various methods of detection of C.parvum and correlate the CD4 counts with the incidence of cryptosporidiosis. Materials and methods Stool samples were collected from 110 HIV positive patients presenting with and without diarrhoea at RIMS, Raichur after obtaining informed consent. Each stool sample was divided into four parts and subjected to modified Ziehl Neelsen staining method, immunofluorescent microscopy, ELISA and PCR. Abstract BLDE Deemed To Be UniversityVijayapura, Karnataka Page2 Results Out of 110 cases studied, 65 patients presented with diarrhoea and the remaining 45 were without diarrhoea. The major group affected was 31- 40 years with mean age 34.4 years. Male preponderance was seen. Out of 110 patients, 80 (73%) patients had CD4 count less than 200 cells/cumm. Maximum positivity was detected by ELISA i.e. 95.4% followed by Immunofluorescent Microscopy 92.6%, Modified ZN staining 77.3% and PCR 66.4%.In the present study 65 patients had diarrhoea as the predominant manifestation, followed by diarrhoea and weight loss in 63, weight loss and fever in 50 and fever in 45 patients. Conclusion Our study highlights the importance of routine examination of stool samples for cryptosporidium oocysts in all HIV sero-positive /AIDS patients, irrespective of gastrointestinal symptoms. ELISA was found to be the most reliable method for diagnosis.