Review of opportunistic parasite infection in HIV / AIDS patients: Clinical symptoms, risk factors and diagnosis

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Illustration: HIV/AIDS. (Source: Lifestyle Okezone.com)

Some parasitic infections have no symptoms, symptoms appear from the accompanying diseases. So it is often called opportunistic disease. Opportunistic parasitic infections are infections of parasitic species that are mild or asymptomatic in immunocompetent people; however, in people with compromised immune systems, it can be fatal.  

One of the diseases that cause immune system disorders is infection with the Human immunodeficiency virus (HIV) which causes a disease called Acquired Immunodeficiency Syndrome (AIDS). The presence of opportunistic parasitic infections in people with HIV indicates that they are in AIDS phase. Most of these infections are severe, and often contribute to the death of the infected person.

Some parasites are the most frequent cause of opportunistic infections include Toxoplasma gondii , Cryptosporidium parvum , isospora belli , Cyclospora cayetanensis , Microsporidia , Cryptococcus neoformans , P neumocystis carinii , P jiroveci , and Entamoeba ( Entamoeba histolytica, Iodamoeba butschlii ). Other parasites that have also been found to aggravate people with HIV / AIDS are: Taenia , Blastocystis hominis , Strongyloides stercoralis, Opisthorchis viverrini ,Cryptosporidium parvum, Enterocytozoon bieneusi, Giardia lamblia, Sarcocystis.

Most of these parasites, which are opportunistic, live in the digestive tract except for Toxoplasma gondii. As it involves the digestive tract, the clinical symptom that often accompanies HIV / AIDS sufferers is diarrhea. Toxoplasma gondii infects all cell types including brain cells, so HIV / AIDS patients infected with T. gondii will show fatal symptoms of encephalitis.

Some researchers showed that the risk factors for a person being infected with HIV / AIDS were higher for male, unemployment, living in urban areas, and married. However, other studies have found that women, housewives, and traffickers are also at risk of contracting HIV / AIDS.

The risk factors for HIV / AIDS patients getting infected with certain intestinal parasites depend on the parasite endemicity in the community. Low levels of environmental hygiene, personal hygiene, fecal contamination in food and drinking water, and poor housing facilities are risk factors for parasite infection.

Low CD4 cell counts in HIV patients were also a risk factor associated with a higher prevalence of opportunistic parasitic infections. A CD4 + count

Diagnosis of intestinal parasite infection in HIV patients to determine organisms in stool samples by the formalin-ethyl concentration technique method for protozoa and worms, modified acid-resistant staining for coccidia (C. parvum , I. belli , C. cayetanensis , and S. hominis), while microspore examination was carried out with Trichrome staining. Molecular examinations both serologically and DNA detection have also been widely developed. There are many tools (diagnostic kits) used to detect parasites.

Author: Lucia Tri Suwanti et al

A full review can be viewed in our article entitled:

Opportunistic parasitic infections in patients with human immunodeficiency virus / acquired immunodeficiency syndrome: A review. Vet World . 2020 Apr; 13 (4): 716–725. Published online 2020 Apr 17. doi:  10.14202 / vetworld.2020.716-725 Available at www.veterinaryworld.org/Vol.13/April-2020/15.pdf

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