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Infectious Diseases Diagnosis & Treatment Infectious Diseases Diagnosis & Treatment Aviles J, et al. Infect Dis Diag Treat 4: 136. Research Article DOI: 10.29011/2577-1515.100136. Intestinal Parasitic Infections in Adult Living with HIV in Cochabamba, Bolivia Jorge Aviles1,2*, Jean Cyr Yombi3, Carlos Erostegui2, Maricruz Torrico4, Rosemary Yanez2, Marcelo Rojas1, Daniel Illanes2, Annie Robert1 1Institut de Recherche Expérimentale et Clinique (IREC) Pôle de recherche en Epidémiologie et Biostatistique, Université catholique de Louvain UCL, Brussels, Belgium 2Instituto de Investigaciones Biomédicas IIBISMED, Universidad Mayor de San Simón (UMSS), Cochabamba, Bolivia 3Service de médecine interne et pathologies infectieuses, Centre de Référence SIDA, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium 4Laboratorio de Investigación Biomédica (LABIMED), Universidad Mayor de San Simón (UMSS), Cochabamba, Bolivia *Corresponding author: Jorge Aviles, Institut de Recherche Expérimentale et Clinique (IREC) Pôle de recherche en Epidémiologie et Biostatistique, Université catholique de Louvain UCL, Brussels, Belgium Citation: Aviles J, Yombi JC, Erostegui C, Torrico M, Yanez R, et al. (2020) Intestinal Parasitic Infections in Adult Living with HIV in Cochabamba Bolivia. Infect Dis Diag Treat 4: 136. DOI: 10.29011/2577-1515.100136. Received Date: 21 January, 2020; Accepted Date: 13 February, 2020; Published Date: 18 February, 2020 Abstract Background: Thanks to the widespread use of Antiretroviral Therapy (ART), Human Immunodeficiency Virus (HIV) infection is becoming a chronic manageable disease. In low resources settings where ART is available, but not widely, opportunistic infections such as parasites diseases remain common. These conditions represent a public health problem in the world due to the high prevalence in developing countries and particularly for patients with HIV/AIDS. To date there have been no systematic study on the prevalence of intestinal parasites in people living with HIV/AIDS (PLWHIV) in Bolivia. The study aimed to evaluate the occurrence of intestinal parasitic infections in PLWHIV who attended routine controls at the reference center for HIV control and prevention in Cochabamba (CDVIR) between January 2011 and December 2015. Methods: Ethical approval was obtained prior to the commencement of this study from the Ethics Committees of the Department of Cochabamba-Bolivia and the Universidad Mayor de San Simón, Institute of Biomedical Research (IIBISMED/UMSS). Code: CB-2016-015. A Retrospective Analysis was carried out Based on the reports of the reference laboratory in the city of Cochabamba (LABIMED) using direct parasitological methods founded on the macroscopic and microscopic identification of parasitic elements present in the stool. Data was collected in an Excel spreadsheet, based on reports from the parasitology laboratory, which was transferred for statistical analysis to SPSS 24.0 (SPSS Inc., Chicago IL, USA). The characteristics of the study participants are reported as mean, range and percentage, as appropriate. The test of X2 or Fisher’s exact test was used for all categorical variables. Logistic regression analysis was used to test the associations. A given statistical test was reported significant if it resulted in a p-value <0.05. Results: During the 5-years of the study, a number varying between 313 and 620 patients were assessed each year, and 12 parasitic species were identified. The highest prevalence was 33.2% in 2011 and there was 9.9% of polyparasitism. In 2012, the prevalence was 28.6%, with 8.3% of polyparasitism, in 2013 it reached 30.4% with a polyparasitosis of 7.7%, while in 2014 it was 24. 5%, the lowest in the period, with a polyparasitism rate of 8.5%. Finally, in 2015 the prevalence reached 27.1% with a polyparasitism rate of 7.3%. The most prevalent species in order of frequency were Blastocystis Homminis, Entamoeba coli (non-Pathogen), Giardia Lamblia and Entamoeba histolytica/dispar, respectively. Regression analysis showed no significant association with sex or with consistence of stool sample but prevalence was higher in people under 30 years of age. Conclusion: Taking into account the epidemiological and geographical context, the frequency of presentation of these infections reach practically one third of these population and thus remains a high problem in Bolivia. So, further studies are required to clarify the epidemiology of these infectious diseases in this endemic region. 1 Volume 04: Issue 01 Infect Dis Diag Treat, an open access journal ISSN: 2577-1515 Citation: Aviles J, Yombi JC, Erostegui C, Torrico M, Yanez R, et al. (2020) Intestinal Parasitic Infections in Adult Living with HIV in Cochabamba Bolivia. Infect Dis Diag Treat 4: 136. DOI: 10.29011/2577-1515.100136. Keywords: HIV; Parasites; Prevalence; Reference laboratory to ART, HIV infection is now a chronic manageable disease but the for HIV management of comorbidities such as cardiovascular, renal, liver, co-infections with hepatitis B or C are now the greatest challenges. List of abbreviations In low resources settings where ART is now available, but not ART : Anti-Retroviral Therapy widely, Opportunistic Infections (OIs) such as parasites diseases remain common and continue to be a leading cause of morbidity CDVIR : Reference center for HIV control and and mortality in PLWHIV, because of a severe immunosuppression prevention in Cochabamba caused by either a lack of knowledge of serological status in CI : Confidence intervals patients presenting late with an opportunistic infection as an or HAART : Highly active antiretroviral therapy late manifestation of AIDS, a lack of adherence to antiretroviral treatment, or a therapeutic failure due to resistance to ART [2]. HIV/AIDS : Human Immunodeficiency Virus Parasitic diseases represent a medical, economic and social IIBISMED : Institute of Biomedical Research problem in the world due to its high prevalence in developing LABIMED : Biomedical Research Laboratory / countries and particularly for PLWHIV. It is estimated that Reference laboratory for HIV worldwide, about two billion people are affected by soil transmitted helminthes such as Ascaris lumbricoides, Ancylostoma/Necator PLWHIV : People living with HIV/AIDS spp. and Trichuris trichiura, 50 million by Entamoeba histolytica PNC/VS : National HIV/AIDS Control Program and 2.8 million by Giardia duodenalis (synonymous G. lamblia UMSS : Universidad Mayor de San Simón and G. intestinalis) [3]. The clinical importance of these infections continues to be debated, especially in the case of Blastocystis UNAIDS : Joint United Nations Program on HIV/ Homminis. AIDS Parasitic infections are common among patients with HIV/ SPSS : Statistical Package for Social Science AIDS. These infections are responsible of frequent complications Background in this population such as chronic diarrhea that contributes to the development of malabsorption and malnutrition in AIDS patient; In December 2013, the Joint United Nations Program on its lifetime incidence among HIV-infected patients is estimated HIV/AIDS (UNAIDS) supported the efforts led by countries and to be 30-70% [4]. Intestinal parasites are therefore an important regions to set new targets for increasing HIV treatment beyond cause of morbidity and mortality in PLWHIV. Frequent pathogenic 2015. A powerful momentum is now being built towards a parasites who infect HIV patients are rarely involved agents before new narrative on the treatment of HIV and AIDS. A new, final, the epidemic of HIV/AIDS with prevalence varying considerably ambitious but achievable goal: by 2020, 90% of all people living according to the geographic context and the epidemiological with HIV will know their HIV status, 90% of all people diagnosed profile of each country. will receive antiretroviral therapy, and 90% of all people receiving antiretroviral therapy will have viral suppression [1]. In developing countries, rates as high as 60 to 80% are reported [5-7], with concomitant infections by multiple parasites. At the end of 2015, there were 2.1 million [1.8 million–2.4 Several diagnostic studies in AIDS patients without antiretroviral million] new HIV infections worldwide, adding up to a total of 36.7 therapy indicate that opportunistic infections account for a large million [34.0 million–39.8 million] PLWHIV. Global coverage proportion of cases of chronic diarrhea (75-80%) [1]. The most of ART reached 46% [43–50%], and in Latin America and the common pathogens are usually enteric parasites including some Caribbean, treatment coverage reached 55% [47-64%] [1]. that are unusual and have not been implicated in human disease Because rates of new HIV infections in adults are relatively until the advent of AIDS [8], such as Cryptosporidium spp., static, epidemics in Latin America are generally stable even with a Microsporidium or Isospora belli, for which there are no effective steady decrease in the number of people newly infected with HIV primary prophylaxis guidelines. There is no specific treatment since early 2000s. The total number of people living with HIV in for cryptosporidiosis, whose cure depends on the immunological this region continued to grow and reach 1.8 million [1.5 million- recovery related to ART [9]. The treatment of microsporidiosis also 2.1 million] in 2010, up from 2.0 million [1.7 million-2.3 million] depends on ART, but there are effective complementary drugs. In in 2015 [1]. intestinal or disseminated infections produced by Enterocytozoon Advances in ART allow considering infection
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