HIV/AIDS患者合并肠道原虫感染状况

HIV/AIDS合并肠道寄生虫感染可加速疾病进程,是HIV感染者长期腹泻的主要原因之一,严重者可导致死亡。目前,HIV/AIDS合并肠道原虫感染仍是一个被忽视的公共卫生问题,且其危害性往往被低估。本文就HIV/AIDS合并常见肠道原虫,如人芽囊原虫(Blastocystis hominis)、隐孢子虫(Cryptosporidium spp.)、蓝氏贾第鞭毛虫(Giardia lamblia)和溶组织内阿米巴(Entamoeba histolytica)感染情况进行综述,以了解全球经济发展程度不同地区HIV/AIDS合并肠道原虫感染状况,为HIV/AIDS合并肠道原虫感染的防控提供参考。     

美国与墨西哥交界城市缺乏适宜排污设施和饮用水家庭的隐孢子虫和贾第鞭毛虫感染

微小隐孢子虫和蓝氏贾第鞭毛虫是分布广泛的两种寄生于人体肠道的原虫,所导致的隐孢子虫病和贾第虫病均为地方性流行肠道疾病。Redlinger等调查了在美国和墨西哥交界地区城市周围的3个定居点NuevaGaleana ,PlutarcoEliasCalles和Fe lipeAngeles的微小隐孢子虫和蓝氏贾第鞭毛虫感染因素,以研究低收入人群感染贾第鞭毛虫和隐孢子虫在流行病学方面的差异。所调查的3个社区是城市周围不相邻的低发展地区。社区选入的标准包括:低经济收入、缺乏合适的生活用水和排污设施,住房普遍拥挤。调查以家庭为单位,检测标本来自安装的可储存厕所(SIR D…     

四种粪检方法检出肠道原虫的比较

在浙江省嵊泗县嵊山镇民主村共检查189份人粪样本。每份粪便标本均用生理盐水直接涂片法(A)、碘液涂片法(B)、硫酸锌离心浮聚法(C)和汞碘醛离心沉淀法(D)等4种方法各做1次,由1人镜检。 189份标本中检出溶组织内阿米巴、结肠内阿米巴、哈氏内阿米巴、微小内蜒阿米巴、布氏嗜碘阿米巴、蓝氏贾第鞭毛虫等肠道原虫包囊阳性者64人(33.86％)。A法未检出原虫滋养体。、C、D三种方法的检出率依次为22.22％(42/     

美国与墨西哥交界城市缺乏适宜排污设施和饮用水家庭的隐孢子虫和贾第鞭毛虫感染

微小隐孢子虫和蓝氏贾第鞭毛虫是分布广泛的两种寄生于人体肠道的原虫，所导致的隐孢子虫病和贾第虫病均为地方性流行肠道疾病。Redlinger等调查了在美国和墨西哥交界地区城市周围的3个定居点Nueva Galeana，Plutarco Elias Calles和Felipe Angeles的微小隐孢子虫和蓝氏贾第鞭毛虫感染因素，以研究低收入人群感染贾第鞭毛虫和隐孢子虫在流行病学方面的差异。     

几种肠道原虫主要表面蛋白的研究进展

在溶组织内阿米巴、隐孢子虫和蓝氏贾第鞭毛虫的致病过程中,一些表面蛋白发挥着重要的作用,介导了原虫与宿主细胞的粘附以及侵入宿主细胞的过程,本文综述了其主要表面蛋白的研究进展以及在诊断和治疗中的应用。     

腹泻病人隐孢子虫及其他原虫感染粪样检测分析

【摘要】目的 检测分析腹泻病人粪便中隐孢子虫及其他原虫感染情况,为该病的诊断、防治提供科学依据。 材料与方法 用直接涂片法、碘液染色、改良抗酸染色法和金胺酚染色法作为病原学检测的金标准,同时联用ELISA、免疫试条法和FTA巢式PCR法,对临床111例腹泻病人隐孢子虫及其他原虫感染情况进行粪样检测分析。结果 111例腹泻病人中男性为65人,女性为45人,年龄在6～65岁,原虫检出率达到44%（49/111）,感染对男女年龄无显著性差别（p>0.05）。其中,用直接涂片法和碘液染色法检测阿米巴原虫感染的阳性率为2.7%（3/111）,人芽囊原虫感染的阳性率为34%（38/111）,没有查到蓝氏贾第鞭毛虫;改良抗酸染色法加金胺酚染色法,隐孢子虫感染的阳性率为8.1%（9/111）,微孢子虫阳性率为1.8%（2/111）;隐孢子虫ELISA试剂盒法检测隐孢子虫感染的阳性率为6.3%（7/111）;隐孢子虫免疫试条法检测的隐孢子虫感染的阳性率为2.7%（3/111）;巢式PCR法检测隐孢子虫感染的阳性率达到9%（10/111）;经过测序后为微小隐孢子虫和猫隐孢子虫。 结论 联合多种检测手段能提高肠道原虫的检出率,腹泻病人感染的原虫主要为隐孢子虫和人芽囊原虫。     

约旦河西岸纳布卢斯地区肠道寄生虫感染的流行和季节变动

作者对1981～1986年间在纳布卢斯中央医学实验室就诊的22 970例病人的新鲜粪便进行了肠道寄生虫检查,粪便首先经肉眼检查有无虫体,再作直接涂片及离心检查沉淀,另作碘液涂片查包囊。结果显示,其中7 412例病人肠道寄生虫感染阳性,总阳性率为32.3％。共发现9种寄生虫。原虫感染的总阳性率为30.7％,溶组织内阿米巴感染率22.9％,蓝氏贾第鞭毛虫感染率7.3％;蠕虫的总阳性率为7.2％,蛔虫感染率5.7％。在所有感染阳性病例中原虫感染达95.5％,蠕虫感染则为22.4％。溶组织内阿米巴的阳性率最高达70.9％,蓝氏贾第鞭毛虫次之为     

我国农村HIV/AIDS高流行地区肠道寄生虫感染现况调查

目的了解我国农村HIV/AIDS高流行地区HIV和肠道寄生虫合并感染状况。方法采用横断面调查方法,在安徽省阜阳市2个自然村开展流行病学调查,检测居民HIV和寄生虫感染情况。结果共调查769人,其中720人参与了9种常见肠道寄生虫的检测,蛔虫、钩虫、鞭虫、华支睾吸虫、人芽囊原虫、蓝氏贾第鞭毛虫、阿米巴原虫、隐孢子虫、粪类圆线虫感染率分别为0.56%、4.03%、0.28%、0.42%、21.39%、3.89%、1.67%、4.44%、0。肠道蠕虫总感染率为4.72%,原虫总感染率为24.31%;贫血患病率为34.68%;HIV感染率为8.10%;HIV合并肠道蠕虫感染率为2.17%,合并肠道原虫感染率为28.26%,其中合并人芽囊原虫感染率为19.57%;HIV阳性和HIV阴性人群合并隐孢子虫感染率分别为13.04%和4.70%,两者差异有统计学意义(P<0.05)。结论当地肠道蠕虫感染率低,肠道原虫感染率高,HIV阳性人群对隐孢子虫易感性增高。     

1995-2003年间汉城国立大学医院就诊的HIV感染者的寄生虫感染

调查1995-2003年间到汉城国立大学医院就诊的105名人类免疫缺陷病毒(HIV)感染者中寄生虫感染率。收集其粪便、痰液或支气管肺泡灌洗液(BAL)。共获67份粪便,60份痰液或BAL(20人提供双份样品)。同时查阅11例兼有寄生虫及HIV感染者的病史记录,包括腹泻和发热史、CD4+T细胞计数、体重减少、治疗措施和效果。67例粪检患者的平均年龄为39.2岁,16人(23.9%)有肠道和肝寄生虫感染,男性占大部分,年龄多在30~50岁。主要是机会性原虫,最普遍的是微小隐孢子虫(10.5%),其次是贝氏等孢球虫(7.5%)和蓝氏贾第鞭毛虫(1.5%)。3名患者有蠕虫感染。11名寄…     

宠物犬蓝氏贾第鞭毛虫和隐孢子虫感染的分子检测

目的了解皖浙两省部分城镇地区宠物犬蓝氏贾第鞭毛虫和隐孢子虫感染情况,及聚集体类型或虫种。方法在安徽多地和浙江杭州共采集315份新鲜宠物犬粪样,分别采用基于蓝氏贾第鞭毛虫谷氨酸脱氢酶(GDH)基因的半巢式PCR和隐孢子虫核糖体小亚基(SSU r RNA)基因的巢式PCR方法对所有粪样进行扩增,并对获得的阳性扩增产物进行测序和生物信息学分析,确定蓝氏贾第鞭毛虫的聚集体和隐孢子虫的虫种类型。结果 315份犬粪样中,蓝氏贾第鞭毛虫和隐孢子虫的阳性率分别为3.2%(10/315)和1.6%(5/315)。幼龄犬(≤12个月)蓝氏贾第鞭毛虫阳性率(17.8%)和隐孢子虫阳性率(11.1%)均显著高于成年犬(0.7%和0)(P0.05)。雌性犬和雄性犬蓝氏贾第鞭毛虫和隐孢子虫阳性率差异均无统计学意义(P0.05)。发现蓝氏贾第鞭毛虫两种聚集体类型,即聚集体B(n=6)和聚集体D(n=4)。从5份阳性犬粪中分离的隐孢子虫经巢式PCR SSU r RNA基因检测,均为犬隐孢子虫(Cryptosporidium canis)。结论皖浙两省部分地区宠物犬蓝氏贾第鞭毛虫和犬隐孢子虫的阳性率分别为3.2%和1.6%。发现的蓝氏贾第鞭毛虫聚集体类型为聚集体B和聚集体D。     

Intestinal parasitic infections in HIV/AIDS and HIV seronegative individuals in a teaching hospital, Ethiopia

The magnitude of intestinal parasitic infection in human immunodeficiency virus (HIV) /AIDS patients requires careful consideration in the developing world. However, there have been very few studies addressing this issue in Ethiopia. This study was conducted to determine the prevalence of intestinal parasitic infection in HIV/AIDS patients at Jimma Hospital, Southwest Ethiopia, between January and February 2002. Stool specimens from HIV/AIDS patients and control groups were screened for intestinal parasitic infections using direct and formalin-ether sedimentation concentration methods. Out of 78 HIV/AIDS patients, 52.6% (41/78), and out of 26 HIV-negative individuals, 42.3% (11/26), were infected with one or more types of intestinal protozoa and/or helminthes. The parasites detected among HIV/AIDS patients included Ascaris lumbricoides (30.8%), Blastocystis spp. (14.1%), Entamoeba histolytica (10.3%), Trichuris trichiura (6.4%), Strongyloides stercoralis (5.1%), Giardia lamblia (3.8%), Schistosoma mansoni (2.5%), hookworm species (2.5%), and Taenia spp. (1.3%). Multiple infections were more common among HIV/AIDS patients. Blastocystis spp. were found to be significantly higher in HIV/AIDS patients than in controls (P < 0.05). The magnitude of intestinal parasitic infection was high both in HIV/AIDS patients and in controls. Routine examinations of stool samples for parasites would significantly benefit the HIV-infected and uninfected individuals by contributing to reduce morbidity.     

Intestinal parasite infestation in HIV infected patients

One of the major health problems among HIV-infected patients is the intestinal parasite infestations. It can be seen that intestinal helminth infestation in HIV-infected patients is common. However, the reported prevalence is usually similar to those of non HIV-infected patients in the same setting. The infestations are ordinary not opportunistic, hence, thus usually show no correlation to immune status of the patients. The suppression of immunity due to HIV infection shows no significant role in increasing the intestinal helminth infestations. On the other hand, having occult intestinal helminth infestations does also not worsen the outcome of HIV infection. Concerning the clinical manifestation, most of the helminth infestations are asymptomatic and the diagnosis is usually based on the stool examination. Treatments of the infestations as well as the outcomes are usually similar to immunocompetent host. Intestinal protozoa infestations are also important problems for HIV-infected patients. Some infections are ordinary, while the others are opportunistic infection. The important opportunistic intestinal parasites including C. parvum, I. belli, Cyclospora and the Microsporidia are found at high prevalence among the HIV-infected patients, especially in low immune cases with persistent diarrhea. Concerning the clinical manifestation, most of the infestations bring diarrhea and the diagnosis is usually based on the stool examination with special stains. The treatment of the opportunistic infection can usually get control of the present illness but not prevent the re-infection. Luckily, with the present wide distribution of HAART, the prevalence of the opportunistic intestinal protozoa infections is significantly decreased.     

Detection of HIV-1 in Entamoeba histolytica without evidence of transmission to human cells

Intestinal protozoa like Entamoeba histolytica and Giardia lamblia have been proposed as vectors or cofactors in the development of AIDS. To determine whether these protozoa could transmit HIV, laboratory strains of protozoa were cocultured with cells chronically infected by a highly replicative strain of HIV-1. Entamoeba histolytica, but not Giardia lamblia, took up virus. Immunologically detectable HIV-1 was present in the amebae up to 48 h after exposure to infected cells, but this virus could not be transferred to uninfected human cells. Amebae isolated directly from two HIV-infected individuals were also found to be positive for HIV-1. After lysis of these protozoa and coculture with uninfected peripheral blood mononuclear cells, no transfer of virus to the human cells was observed.     

Intestinal parasitic diseases in HIV-infected patients in Uzbekistan

Intestinal parasitic diseases were diagnosed in 100 HIV-infected patients at different stages of disease (its asymptomatic form, persistent generalized lymphoadenopathy, pre-AIDS, and AIDS) (Group 1), 100 Tashkent residents (Group 2), and 349 patients with gastrointestinal diseases, allergic dermatoses, and skin depigmentation foci (Group 3). The HIV-infected patients were found to have virtually all parasites, such as Giardia lamblia, Cryptosporidium parvum, Chilomastix mesnili, Entamoeba coli, Iodamoeba butschlii, Entamoeba histolytica/dispar, Endolimax nana, Blastocystis hominis, Enlerobius vermicularis, Ascaris lumbricoides, Hymenolepis nana, detectable in the population of Tashkent. The highest infestation with intestinal protozoa, including nonpathogenic amoebas and helmninths, was found in Groups 1 and 3. However, in all the forms of HIV infection, the infestation with E. histolytical/dispar was 10 times greater than that in Groups 2 and 3 (1% and 0.8%, respectively). G. lamblia was detected in 16, 21, and 45.2% in Groups 1, 2, and 3, respectively. In all the HIV-infected patients, the content of CD8 lymphocytes was increased, but that of CD20 lymphocytes was normal. Parasites were detectable with different levels of CD4 lymphocytes, but C. parvum was found only if its count was > 200/ml. In the HIV-infected patients, the hyperproduction of IgE was caused mainly by helminths rather than protozoa. In these patients, the increased level of IgE was also noted in the absence of parasites.     

Prevalence of intestinal parasite infections among patients in local public hospitals of Hail,Northwestern Saudi Arabia

Objective:To evaluate the prevalence of intestinal parasites among patients in Hail,Northwestern Saudi Arabia.Methods:Stool samples were collected from 130 patients(69females and 61 males) in Hail General Hospital.Each sample was examined by direct wet mount microscopic examination using both normal saline and Lugol's iodine preparation and concentration techniques using salt and formol-ether solutions.Permanent stained smears were performed for intestinal coccidian using modified Ziehl-Neelsen technique.Results:The overall prevalence of intestinal parasitic infection was 45.38%(59 cases).Forty-four(33.84%)were found to be infected with one or more intestinal protozoa.5(3.84%) were infected with helminthes and 10(7.69%) had mixed infection with both helminthes and protozoa.The most common intestinal helminth detected was Ancyloxtoma duvdenale(n=5.3.84%),followed by Ascaris lumlmcnidex.Taenia sp.and Trichuris trichiura(n=2 for each species,1.5%).For intestinal protozoa,the coccidian Cryptosporidium parvum(n=25,19.23%) was the most common followed by Entamoeba histolytica/dispur(n=21,16.15%),Giurdia lamblia(n=15,11.54%),Entamoeba coli(n=5.3.85%) and Blastocysts hominis(n=3,2.30%).The prevalence of intestinal parasitic infections in females was significantly higher than in males(P0.05).Conclusions:This is the first study highlighting that intestinal parasites are still an important public health problem in Northwestern Saudi Arabia Therefore,health education would be the best way to prevent from intestinal parasite infections which are mainly food borne diseases.     

Epidemiology and control of intestinal parasites with nitazoxanide in children in Mexico

The purpose of this study was to evaluate the efficacy and the tolerance of nitazoxanide in children as a single broad-spectrum antiparasitic agent in the treatment of mixed parasite infections with both intestinal protozoa and helminths. Two hundred seventy-two children (age range = 2-14 years) participated in this study. We systematically surveyed every household head using questionnaires designed to obtain information about household socioeconomic status and hygiene. Parasitic infections were confirmed by three stool examinations using direct smear, Ferreira concentration, and cold acid-fast Kinyoun staining methods. One hundred twenty-one (44%) children tested positive for protozoa such as Giardia lamblia (18%), Entamoeba histolytica/E. dispar (10%), Blastocystis hominis (7%), Cryptosporidium parvum (4%), and Cyclospora cayetanensis (3%), and helminths such as Hymenolepis nana (10%), Trichuris trichiura (6%), and Ascaris lumbricoides (6%). There were also two cases of infection with Enterobius vermicularis. After a complete physical examination was performed, 121 patients received treatment with nitazoxanide. Overall, 84% of the protozoa and 95% of the helminths were completely eliminated from the patients. Nitazoxanide was very well tolerated, with no serious adverse effects reported.     

The prevalence and clinical significance of intestinal parasites in HIV-infected patients in Denmark

To investigate the prevalence and clinical significance of intestinal parasites in human immunodeficiency virus (HIV)-infected patients, faecal specimens from 96 HIV-infected patients were submitted to microbiological analyses, including microscopy and polymerase chain reaction for protozoa and enteropathogenic bacteria. Results of microbiological analyses were compared with self-reported gastrointestinal complaints collected using a validated questionnaire. Thirty-two (33%) patients were positive for parasites. However, opportunistic parasites (Isospora and Cryptosporidium) were detected in only 2 instances. Entamoeba dispar was detected in 10 cases, 9 of which represented men who have sex with men (MSM). Despite generally low HIV RNA loads and high CD4+ T-cell counts, 42% of the 76 patients reporting symptoms complained of diarrhoea, 31% of whom were parasite-positive. The presence of diarrhoea was not associated with the presence or absence of parasites; neither was it associated with receiving highly active anti-retroviral therapy (HAART) in general, or protease inhibitors (PI) in particular. A CD4+ T-cell count <200 cells/mm3 was not associated with parasitic infection or with diarrhoea. The data show that diarrhoea is a common symptom among HIV-infected patients in Denmark, but do not indicate that the diarrhoea is due to intestinal parasites.     

Microsporidiosis in Venezuela: prevalence of intestinal microsporidiosis and its contribution to diarrhea in a group of human immunodeficiency virus-infected patients from Zulia State

Microsporidia are recognized as a cause of morbidity among patients infected with the human immunodeficiency virus (HIV). Infection rates for intestinal microsporidiosis in HIV-infected patients from Venezuela are unknown. To determine the prevalence and pathogenic role of microsporidia in these patients in northwestern Venezuela, a case control study was conducted in 103 outpatients (mean +/- SD age = 37.3 +/- 5.6 years). Microsporidia were detected using unconcentrated formalin-fixed stools examined by Weber's chromotrope-based staining method. For identification of coccidia, modified Ziehl-Neelsen carbolfuchsin staining of formalin-ether concentrates were used, and for other pathogenic parasites, iron hematoxylin-stained smears and formalin-ether concentrates were examined. Microsporidial infections were detected in 14 (13.6%) of 103 patients and 39 (37.9%) had other parasitic pathogens. No significant difference was noted in the occurrence of the infection in patients with diarrhea (13 of 74, 17.6%) and controls (1 of 29, 3.4%) (P = 0.118). Nevertheless, this result may be due to the small sample size (n = 14) of infected individuals. The proportions of other pathogens in patients with or without diarrhea were not significantly different (P = 0.828). Microsporidiosis is common among the HIV-infected population in northwestern Venezuela. However, its pathogenic role in these patients is uncertain and warrants further investigation.     

Intestinal parasitic infections in schoolchildren of Abha (Asir), Saudi Arabia.

Stool specimens from 1282 children between the age of 5 and 13 years attending 10 primary schools for boys in the city of Abha, southwestern Saudi Arabia, were examined for the presence of intestinal parasites. Of these, 313, (24.4%) were found infected with one or more species of 11 intestinal protozoa and helminths. The most common pathogenic protozoa being Giardia lamblia (10.9%) followed by Entamoeba histolytica (4.1%). The nonpathogenic protozoan, Entamoeba coli had the highest prevalence rate (11.3%) in the children's stools. Hymenolepis nana was the commonest intestinal helminth (3.0%). Other intestinal helminths, including Ascaris lumbricoides, Trichuris trichiura. Schistosoma mansoni, Dicrocoelium dendriticum were detected to a lesser extent. The distribution of the common intestinal infections among the children surveyed were also analysed according to age, nationality and multiplicity of infection. Prevalence of E. histolytica was found to increase with age whereas Giardia infections were less common among older children. This pair of parasite species were strongly associated. Yemeni children had consistently the highest prevalence of infection with protozoa and helminths, followed by Saudi and non-Saudi children.     

Intestinal parasites in patients with diarrhea and human immunodeficiency virus infection in Zimbabwe.

OBJECTIVES: To determine the prevalence of intestinal parasites and risk factors for infection associated with diarrhea in HIV-infected patients in Harare, Zimbabwe. DESIGN: Prospective observational study. METHODS: Single stool samples were collected from 88 HIV-infected individuals presenting with diarrhea of greater than 1 week duration. Stools were examined for intestinal parasites using modified acid fast stain, fluorescence- labeled monoclonal antibody for Cryptosporidium parvum, as well as a modified trichrome stain and a PCR-based protocol for Enterocytozoon bieneusi. RESULTS: C. parvum was detected in 9% (seven out of 82) of samples evaluated, but no Cyclospora was detected. E. bieneusi was detected in 18% (10 out of 55) of stool by trichrome staining and in 51% (28 out of 55) of stool examined by PCR. Risk factors for E. bieneusi infection were: living in rural areas, consumption of nonpiped water, contact with cow dung and household contact with an individual with diarrhea. CONCLUSION: E. bieneusi infection was common in HIV-infected patients with diarrhea in Zimbabwe and may be acquired through person-to-person and fecal-oral transmission.