Is the evaluation of Entamoeba histolytica infection in HIV-positive patients of any clinical significance?

  • Alireza Abdollahi Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Thrombosis Hemostasis Research Center, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Hana Saffar Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Hiva Saffar Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Sara Sheikhbahaei Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Mehrnaz Rasoulinejad Department of Infectious Diseases, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Entamoeba histolytica, Seroprevalence, HIV infection

Abstract

Amoebiasis caused by Entamoeba histolytica (E. histolytica) is one of the most problematic parasitic infections worldwide. Data regarding the effect of HIV-induced immunodeficiency on the status of E. histolytica infection are sparse in Iran. This study aimed to assess the seroprevalence of anti-E. histolytica IgG among Iranian HIV patients. Further, it determined whether the advancement of immunodeficiency accompanies an increased risk of amoebiasis. A total of 91 HIV-infected patients and 91 controls were enrolled in this case-control study. Controls were matched to cases with respect to age, gender, and where possible socioeconomic status. Patients with a history of treatment for intestinal parasitism within last two weeks were not included in the study. Blood samples were obtained from all participants. Serum IgG against E. histolytica measured using a commercial enzyme-linked immunosorbent assay (ELISA). The mean serum anti-E. histolytica IgG was significantly higher in HIV patients than controls (9.34 ± 4.18 vs. 2.07 ± 0.60, P<0.001). HIV-infected patients showed a significantly higher positive serology for E. histolytica IgG comparing healthy controls (30.8% vs. 0% P<0.001). There was no statistical difference in the serology of E. histolytica among AIDS stage and non-AIDS HIV patients. This study demonstrated that HIV is significantly associated with higher prevalence of E. histolytica infection. Early evaluation and treatment of E. histolytica in this population is recommended to prevent and control this infection.

References

Haque R, Huston CD, Hughes M, et al. Current concepts: amebiasis. N Engl J Med 2003;348(16):1565-73.

Reza A, Iqbal Z, Muhammad G, et al. Amoebiasis as a major risk to human health: a review. Int J Mol Med Sci 2013;3(3):13-24.

Ali IK, Clark CG, Petri WA Jr. Molecular epidemiology of amebiasis. Infect Genet Evol 2008;8(5):698-707.

Walsh JA. Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality. Rev Infect Dis 1986;8(2):228-38.

WHO/PAHO/UNESCO report. A consultation with experts on amoebiasis. Mexico City, Mexico 28-29 January, 1997. Epidemiol Bull 1997;18(1):13-4.

Pinlaor S, Mootsikapun P, Pinlaor P, et al. Detection of opportunistic and non-opportunistic intestinal parasites and liver flukes in HIV-positive and HIV-negative subjects. Southeast Asian J Trop Med Public Health2005;36(4):841-5.

Ohnishi K, Kato Y, Imamura A, et al. Present characteristics of symptomatic Entamoeba histolytica infection in the big cities of Japan. Epidemiol Infect 2004;132(1):57-60.

Stanley SL Jr. Amoebiasis. Lancet 2003;361(9362):1025-34.

Fotedar R, Stark D, Beebe N, et al. Laboratory diagnostic techniques for Entamoeba species. Clin Microbiol Rev 2007;20(3):511-32.

Hung CC, Ji DD, Sun HY, et al. Increased risk for Entamoeba histolytica infection and invasive amebiasis inHIV seropositive men who have sex with men in Taiwan. PLoS Negl Trop Dis 2008;2(2):e175.

Watanabe K, Gatanaga H, Escueta-de Cadiz A, et al. Amebiasis in HIV-1-infected Japanese men: clinical features and response to therapy. PLoS Negl Trop Dis 2011;5(9):e1318.

Park WB, Choe PG, Jo JH, et al. Amebic liver abscess inHIV-infected patients, Republic of Korea. Emerg Infect Dis 2007;13(3):516-7.

James R, Barratt J, Marriott D, et al. Seroprevalence ofEntamoeba histolytica infection among men who have sex with men in Sydney, Australia. Am J Trop Med Hyg 2010;83(4):914-6.

WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-Related Disease in Adults and Children. 2007. World Health Organization. (Accessed in Jan 2014, 14, at http://www.who.int/hiv/pub/guidelines/HIVstaging150307. pdf).

Zali MR, Mehr AJ, Rezaian M, et al. Prevalence of intestinal parasitic pathogens among HIV-positive individuals in Iran. Jpn J Infect Dis 2004;57(6):268-70.

Mohandas, Sehgal R, Sud A, et al. Prevalence of intestinal parasitic pathogens in HIV-seropositive individuals in Northern India. Jpn J Infect Dis 2002;55(3):83-4.

Teklemariam Z, Abate D, Mitiku H, et al. Prevalence of Intestinal Parasitic Infection among HIV Positive Persons Who Are Naive and on Antiretroviral Treatment in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. ISRN AIDS 2013;2013:324329.

Moran P, Ramos F, Ramiro M, et al. Entamoeba histolytica and/or Entamoeba dispar: infection frequency in HIV+/AIDS patients in Mexico city. Exp Parasitol 2005;110(3):331-4.

Samie A, Barrett LJ, Bessong PO, et al. Seroprevalence of Entamoeba histolytica in the context of HIV and AIDS: the case of Vhembe district, in South Africa's Limpopo province. Ann Trop Med Parasitol 2010;104(1):55-63.

Hung CC, Chen PJ, Hsieh SM, et al. Invasive amoebiasis: an emerging parasitic disease in patients infected with HIV in an area endemic for amoebic infection. AIDS 1999;13(17):2421-8.

Chen Y, Zhang Y, Yang B, et al. Seroprevalence of Entamoeba histolytica infection in HIV-infected patients in China. Am J Trop Med Hyg 2007;77(5):825-8.

Tsai JJ, Sun HY, Ke LY, et al. Higher seroprevalence of Entamoeba histolytica infection is associated with human immunodeficiency virus type 1 infection in Taiwan. Am J Trop Med Hyg 2006;74(6):1016-9.

Zhou F, Li M, Li X, et al. Seroprevalence of Entamoeba histolytica infection among Chinese men who have sex with men. PLoS Negl Trop Dis 2013;7(5):e2232.

Hira PR, Iqbal J, Al-Ali F, et al. Invasive amebiasis: challenges in diagnosis in a non-endemic country (Kuwait). Am J Trop Med Hyg 2001;65(4):341-5.

How to Cite
1.
Abdollahi A, Saffar H, Saffar H, Sheikhbahaei S, Rasoulinejad M. Is the evaluation of Entamoeba histolytica infection in HIV-positive patients of any clinical significance?. Acta Med Iran. 53(1):46-50.
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