Opportunistic parasitoses among Egyptian hemodialysis patients in relation to CD4+ T-cell counts: a comparative study

• Published in: BMC infectious diseases 2019-05, Vol.19 (1), p.480-480, Article 480
• Main Authors: Shehata, Amany I, Hassanein, Faika, Abdul-Ghani, Rashad
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Antibodies; Antigens; Blood; Blood levels; Care and treatment; CD4 antigen; CD4 lymphocytes; CD4+ Tcell; Comparative literature; Comparative studies; Containers; Counting; Cryptosporidium; Dialysis; Diarrhea; EDTA; Egypt; Enzymes; Ethylenediaminetetraacetic acids; Flow cytometry; Health aspects; Health care; Helminthiasis; Hemodialysis; Hemodialysis patients; HIV; Hospitals; Human immunodeficiency virus; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Infection; Infections; Informed consent; Intestinal parasites; Intestinal parasitosis; Intestine; Laboratories; Lymphocytes T; Medical research; Microsporidia; Parasites; Parasitic diseases; Physiological aspects; Prevalence studies (Epidemiology); Protozoan diseases; Risk factors; Samples; Serology; Species; Statistical analysis; Statistical methods; Statistical significance; Statistics; Systematic review; T cells; Toxoplasma gondii; Toxoplasmosis
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-4110-4

Some reports are available on the prevalence of opportunistic parasitoses among hemodialysis (HD) patients, yet there is a paucity of data on the association of CD4+ T-cell counts with such infections. Therefore, this study aimed to determine the prevalence of intestinal parasites and Toxoplasma gondii in relation to CD4+ counts among HD patients in Alexandria, Egypt. A comparative cross-sectional study was conducted on 120 HD patients and 100 apparently healthy individuals between December 2014 and January 2016. Data and samples (stool and blood) were collected from the participants after obtaining their informed consent. Stool samples were examined for parasites after concentration and staining, EDTA-blood samples were used for CD4+ counting by flow cytometry, and sera were analyzed for anti-Toxoplasma IgM and IgG antibodies. A significantly higher prevalence rate of intestinal parasitoses was found among HD patients compared to apparently healthy individuals (52.5% vs. 12.0%, respectively), with absence of helminths. Cryptosporidium species (32.5%), B. hominis(24.2%) and microsporidia (11.7%) were the most frequent parasites among HD patients, while B. hominis (13.0%), Cryptosporidium species (11.0%) and G. lamblia (4.0%) were the most frequent parasites among their counterparts. Statistically significant differences in parasite infection rates between patients and their counterparts were found for Cryptosporidium species, B. hominis and microsporidia. However, parasite species were not significantly associated with diarrhea. On the other hand, the overall T. gondii seroprevalence rate among HD patients was significantly higher than that among their counterparts (33.3% vs. 8%, respectively). HD patients with CD4+ counts