%0 Journal Article
%T Clinical and Microbiological Profile of HIV/AIDS Cases with Diarrhea in North India
%A Arun Kumar Jha
%A Beena Uppal
%A Sanjim Chadha
%A Preena Bhalla
%A Roumi Ghosh
%A Prabhav Aggarwal
%A Richa Dewan
%J Journal of Pathogens
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/971958
%X Intestinal infections are a significant cause of morbidity and mortality in people living with HIV/AIDS (PLWHA) especially in developing countries. The present study was conducted to assess the clinical and microbiological spectrum in HIV/AIDS cases with diarrhea and to correlate the occurrence of such pathogens with stool characters, HIV seropositivity status, and CD4 counts. Stools from 154£¿HIV seropositive subjects and 50£¿HIV negative controls were examined by direct microscopy, fecal cultures, and serological tests (Clostridium difficile Toxin A, Cryptosporidium antigen, and Entamoeba histolytica antigen ELISA). CD4 T cell enumeration was done using FACS count (Becton Dickinson). The study showed a male preponderance (112 males and 42 females). Weakness, abdominal pain, and anorexia were the most common symptoms. Coccidian parasites were the most common cause of diarrhea in HIV seropositive cases. C. parvum was seen in 60.42% while Isospora belli in 9.03%. Amongst the bacterial pathogens C. difficile was detected in 18.06%, diarrheagenic Escherichia coli in 11.11%, and Shigella spp. in 2.78%. Pathogen isolation rates were more in HIV seropositive cases and subjects with low CD4 T lymphocyte counts. Regular monitoring of CD4 T lymphocyte counts and screening for enteric pathogens will help improve the quality of life for PLWHA. 1. Introduction Infection with human immunodeficiency virus (HIV) imposes monumental suffering on afflicted individuals, and in the developing world in particular it places a great burden on the medical system [1]. For a poverty-stricken and disease-ravaged country like India, the scourge of HIV/AIDS is most unfortunate. One of the major health problems among HIV seropositive patients due to a waning immunity is superimposed opportunistic infections, and it is often seen that during the course of the disease patients become a microbial zoo [2, 3]. Patients may have several such concurrent infections, resulting in clinical conditions that pose diagnostic and therapeutic challenges [4¨C6]. Diarrhea is one such very common clinical condition in HIV/AIDS and has been included as a criterion for defining a case of AIDS [7, 8]. Episodes of diarrhea may be acute and brief, intermittent or recurrent, or, in some cases, chronic and severe. Diarrhea may significantly diminish patients¡¯ quality of life and if it persists may cause dehydration, poor nutrition, and weight loss [9, 10]. Diarrhea has been associated with 50% of HIV/AIDS patients in the developed world and in up to 100% of patients residing in developing countries [11¨C13]. The
%U http://www.hindawi.com/journals/jpath/2012/971958/