title: Enteric pathogens, immune status and therapeutic response in diarrhea in HIV/AIDS adult subjects from north India.
abstract: Intestinal infection causing diarrheal disease is a dominant contributor to high morbidity and mortality in developing countries. This intervention study aimed to assess the response of specific anti-microbial and anti-retroviral therapy (ART) on enteropathogens identified in HIV/AIDS adult subjects from northern India. Seventy five ART naive (group 1) and seventy five ART adherent (group 2) HIV/AIDS adult subjects with diarrhea were enrolled. Stool samples from all subjects were examined for enteropathogens by wet mount, staining methods, culture and ELISA. Subjects with enteropathogens were started on specific therapy as per National AIDS Control Organisation, Government of India's guidelines. Follow-up stool samples were examined after 2-4 weeks of completion of therapy for persistence/clearing of enteropathogens. CD4+ T lymphocyte count was done for all subjects. At enrollment, group 1 had 26.13% bacterial, 57.66% parasitic & 16.22% fungal pathogens while group 2 had 11.9%, 69.05% & 19.05% pathogens, respectively. Parasitic diarrhea was more common than bacterial diarrhea. The coccidian parasites (Cryptosporidium spp. & Isospora belli) were the common parasites identified. Clearance of enteric pathogens was significant after specific anti-microbial therapy (p = 0.0001). Persistence of enteropathogens was seen primarily for coccidian parasites. Clearance of enteropathogens after specific therapy and the diagnostic yield of stool specimens were influenced by the CD4+ counts. Immune competence coupled with specific anti-microbial therapy displays the best response against enteric pathogens.
authors: Department of Microbiology, Maulana Azad Medical College & Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi-110002, India. dr_jhauc2k@yahoo.co.in.
authors: Arun Kumar
authors: AK
authors: Jha
authors: Beena
authors: B
authors: Uppal
authors: Sanjim
authors: S
authors: Chadha
authors: Prabhav
authors: P
authors: Aggarwal
authors: Roumi
authors: R
authors: Ghosh
authors: Richa
authors: R
authors: Dewan
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology / Q000469:parasitology; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D018791:CD4 Lymphocyte Count; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology / Q000469:parasitology; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D005260:Female; D006801:Humans; D007194:India; D007410:Intestinal Diseases / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010272:Parasitic Diseases / Q000188:drug therapy / Q000469:parasitology; D014777:Virus Diseases / Q000188:drug therapy / Q000821:virology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D044966:Anti-Retroviral Agents