Intestinal Parasites and Liver Flukes in Hiv-positive

We assessed the frequency and distribution of infection with opportunistic and non-opportunistic intestinal parasites and the liver fluke, Opisthorchis viverrini, in HIV-seropositive and HIVseronegative subjects. Ageand sex-matched HIV-seropositive (n=78) and HIV-seronegative patients (n=78) from two hospitals in Khon Kaen Province, Thailand, participated in this study from November 1998 to August 2000. These subjects were divided according to the presence of diarrhea and CD4 counts. A single stool sample was obtained and analyzed by using specific techniques. Opisthorchis viverrini, was the most common parasite (19.2%) in each group. The prevalence rates of Cryptosporidium spp (11.5%) and Strongyloides stercoralis (17.9%) in the HIV-seropositive group were significantly (p<0.05) higher than those in the HIV-seronegative group (1.0% for Cryptosporidium spp and 7.7% for S. stercoralis infections). The prevalences of these two parasites were 28% for Cryptosporidium spp and 20% for S. stercoralis in HIV-seropositives with diarrhea and CD4 counts lower than 100 cells/mm3, and were higher compared with patients without diarrhea or with high CD4 counts. These results suggest that infection with these parasites increases during HIV infection. The epidemiological distribution of Cryptosporidium and S. stercoralis may have implications for AIDS-related diseases. SOUTHEAST ASIAN J TROP MED PUBLIC HEALTH 842 Vol 36 No. 4 July 2005 not been well documented. Therefore, a study of intestinal parasites and liver fluke infections in HIV-infected individuals and AIDS patients is needed. We performed a cross-sectional study of HIV-seropositive and HIV-seronegative individuals in Khon Kean Province, northeastern Thailand. We assessed the frequency and distribution of infection with intestinal parasites and liver fluke infections using several specific techniques. To examine both opportunistic and non-opportunistic parasites, we used simple stool smears and formalin-ether concentration techniques. To examine for coccidial parasites, we used a modified Ziehl-Neelsen stain (Casemore et al, 1985), and a modified trichrome stain for microsporidia infection (Garcia et al, 1994). Positive results for Cryptosporidium were further confirmed by using direct fluorescence techniques. To examine S. stercoralis infection, we used the agar culture plate technique, which is the most sensitive method for detecting this parasite (Jongwutiwes et al, 1999). MATERIALS AND METHODS