title: Pattern of co-infection by enteric pathogenic parasites among HIV sero-positive individuals in a Tertiary Care Hospital, Mumbai, India.
abstract: BACKGROUND
  One of the major medical concerns in people living with HIV/AIDS (PLHA) is management of diarrhea that can lead to severe morbidity and mortality. Such clinical scenario warrants an analysis of intestinal parasites, which are important opportunistic pathogens in PLHA. Owing to the scarcity of recent pattern of intestinal opportunistic infections from this region, the study was designed to determine the opportunistic parasites causing diarrhea in PLHA; and to find out whether there is any significant difference in the enteric parasitic pathogens in patients with different immunological status and in those on highly active anti retro-viral therapy (HAART).
  
  
  METHODS
  Analysis of the spectrum of intestinal parasites was carried out with 192 subjects in two groups (142 HIV sero-positive patients having diarrhea and 50 HIV sero-negative patients having diarrhea). The routine light microscopic examination was carried out to determine the infection and CD4+ T-Lymphocyte count was estimated using flow cytometry.
  
  
  RESULTS
  Enteric parasites were detected in 35.9% of HIV sero-positive patients having diarrhea and 18% of HIV sero-negative patients having diarrhea. Most common opportunistic enteric parasite was Isospora belli (11.5%); others were Entamoeba histolytica (4.7%), Cryptosporidium sp. (3.6%), Strongyloides stercoralis (3.1%), Giardia intestinalis (3.1%) and Cyclospora cayatanenesis (1.6%). Opportunistic enteric parasites were detected in significantly low numbers in patients with CD4+ T-Lymphocyte counts >500 cells/ml; and in those taking HAART.
authors.affiliation: Department of Laboratory Medicine, Delhi State Cancer Institute, New Delhi, India.
authors.forename: Nishat Hussain
authors.initials: NH
authors.lastname: Ahmed
authors.affiliation: Department of Microbiology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
authors.forename: Abhay
authors.initials: A
authors.lastname: Chowdhary
keywords: CD4+ T-Lymphocyte counts; highly active anti retro-viral therapy; opportunistic parasites; people living with HIV/AIDS