Prevalence of Intestinal Parasitic Diseases among HIV Positive Patients using Antiretroviral Treatment in Phayao Province, Northern Thailand

Abstract

Co-infection of intestinal parasites and HIV is widespread, leading to higher morbidity and mortality in tropical countries. Hence, the aims of this study were to determine the prevalence of intestinal parasitic diseases among patients with HIV and their association with immune status. The study was conducted at Phayao and Dok Khamtai Hospitals, Phayao Province, northern Thailand from June 2014 to May 2015. A single stool sample of 458 patients was collected and processed using direct fecal smear, formalin ethyl-acetate concentration and modified Ziehl-Neelsen staining. Basic information was collected on sociodemographics, diarrhea status and current CD4⁺ T-cell counts of each patient. The results showed a high prevalence (33.0%) of intestinal parasites in this population with no significant difference observed by age (p=0.296), sex (p=0.484) and diarrhea status (p=0.947). The rates of single and multiple infections were 27.4% and 5.2%, respectively. Numbers of Giardia lamblia (35.2%), Cryptosporidium parvum (28.5%) and Strongyloides stercoralis (26.2%) were high among patients whose CD4⁺ T-cell count was lower than 200 cells/µL. However, the number of intestinal parasites showed no correlation with CD4⁺ T-cell counts. Therefore, laboratory diagnosis of intestinal parasites is essential for patients with HIV regardless of receiving antiretroviral treatment, CD4⁺ T-cell count or experiencing diarrhea.