HIV Pozitif Hastalarda Visseral Leishmaniasis ve Intestinal Parazitlerin Koenfeksiyonunun Araştırılması
Öz
Amaç: Paraziter enfeksiyonlar, insan immün yetmezlik virüsü (HIV) ile enfekte olgular gibi immunsüpresif olgularda daha yüksek oranlarda görülmektedir.
Buna ek olarak, immünkompetan olgularla karşılaştırıldığında immünsüpresif hasta grubunda daha ciddi bir klinik seyre yol açmaktadır. HIV pozitif bireylerde parazitlerin patojenitesi artmakta ve mortalite ile sonuçlanabilen değişen şiddetteki klinik semptomlar görülebilmektedir. Visseral leishmaisis (VL)
vektörle bulaşan bir hastalık ve her iki enfeksiyonun endemik olduğu özellikle Güney Avrupa ve Afrika’da HIV/ Acquired Immune Deficiency Syndrome
(AIDS) vakalarında görülen önemli bir fırsatçı enfeksiyondur. Toxoplazmosis, cryptospororidiosis, isosporiasis, cyclosporiasis, amibiazis, giardiazis, plasmodium ve strongylodiasis olmak üzere çeşitli parazitler bu hasta grupları için önemli risk faktörü oluşturan enfeksiyonlardır.
Gereç ve Yöntemler: Çalışmamızda HIV pozitif olguların serum örneklerinden serolojik olarak visseral leishmaniasis ve gaita örneklerinden konvansiyonel
yöntemlerle paraziter enfeksiyonlar araştırıldı.
Bulgular: Çalışmaya dahil edilen 42 olgunun 5’i kadın idi. Bu olguların ortalama yaşı 38.7 (19-66) idi. HIV pozitif olgulardan alınan dışkı örneklerinin
5’inde Blastocystis spp tespit edildi. Serum örnekleri ile çalışılan rK39 dipstick testi sonucunda bir olguda çok zayıf bant elde edilirken, diğer testlerin hiçbiri
pozitif bant vermedi.
Sonuç: HIV pozitif olgularda subklinik olarak seyredebilen bu gizli enfeksiyonların bölgesel prevalansının bilinmesi önemlidir. Ancak literatürde ülkemizdeki durum ile ilgili yeterli veri bulunmamaktadır. Bu çalışmada bölgemizde HIV enfeksiyonu olan kişilerde enterik paraziter enfeksiyon prevalansı düşük
bulunmuştur ve VL tespit edilmemiştir.
Anahtar Kelimeler
Proje Numarası
Project number: 19.M.014
Kaynakça
- UNAIDS, Global HIV & AIDS statistics — 2018 fact sheet
- Markell EK, John DT, Krotoski WA. Medical Parasitology. Eighth edition, Pennsylvania: W.B. Saunders Comp, 1999:389-402
- Koch KL, Phillips DJ, Aber RC, Current WL. Cryptosporidiosis in hospital personel: Evidence for person to person transmission. Ann Intern Med 1985;102:593-596.
- Istre GR, Kreiss K, Hopkins RS, Healy GR, Benziger M, Canfield TM, et al. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. N Engl J Med. 1982 Aug 5;307(6):339-342.
- Sia IG, Paya CV. Renal transplantation. Infectious complications following renal transplantation.Surgical Clinics of North America 1998;78:95-114.
- Alvar J, Aparicio P, Aseffa A, Den Boer M, Canavate C, Dedet JP, et al. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008;21(2): 334e59.
- Alvar J, Canavate C, Gutierrez-Solar B, Jimenez M, Laguna F, Lopez-Velez R, et al. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev 1997;10(2):298e319.
- Cruz I, Nieto J, Moreno J, Canavate C, Desjeux P, Alvar J. Leishmania/HIV co-infections in the second decade. Indian J Med Res 2006;123(3):357e88
- Jarvis JN, Lockwood DN.Clinical aspects of visceral leishmaniasis in HIV infection.Curr Opin Infect Dis. 2013;26(1):1-9.
- ter Horst R, Collin SM, Ritmeijer K, Bogale A, Davidson RN. Concordant HIV infection and visceral leishmaniasis in Ethiopia: the influence of antiretroviral treatment and other factors on outcome.Clin Infect Dis. 2008;46(11)
- del Giudice P, Mary-Krause M, Pradier C, Grabar S, Dellamonica P, Marty P, et al. Impact of highly active antiretroviral therapy on the incidence of visceral leishmaniasis in a French cohort of patients infected with human immunodeficiency virus. J Infect Dis 2002;186:1366e70.
- Cota GF, de Sousa MR, Rabello A. Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. PLoS Negl Trop Dis. 2011;5(6):e1153.
- Redhu NS, Dey A, Balooni V, Singh S. Leishmania-HIV coinfection: an emerging problem in India. AIDS 2006 May 12; 20(8):1213e5.
- Sinha PK, Rabidas VN, Pandey K, Verma N, Gupta AK, Ranjan A, et al. Visceral leishmaniasis and HIV coinfection in Bihar, India. J Acquir Immune Defic Syndr 2003;32(1):115e6.
- Acıpayam C, Çulha G, Altunay A, Akğlu F, Yeral A, Gülkan B. Treatment expreience with liposamal amphotericin B in pediatric patients with kala-azar. Abant Med J 2015;4(3):222-229.
- Ozkan AT, Yalçinkaya T, Kiliç S, Babür C, Schallig HD. HIV/ AIDS hastalarinda Leishmania infantum seropozitifliğinin araştirilmasi [Investigation of Leishmania infantum seropositivity in HIV/AIDS patients]. Mikrobiyol Bul. 2008 Jan;42(1):113-7. Turkish. PMID: 18444568.
- Köse H, Temoçin F. Evaluation of Adult Cases of Visceral Leishmaniasis Reported in Turkey by Pool Analysis Method. Klimik Dergisi. 2020; 33(2): 157-62.
- Desjeux P, Alvar J. Leishmania/HIV co-infections: epidemiology in Europe. Ann Trop Med Parasitol 2003; 1: 3-5.
- Desjeux P, Meert JP, Piot B, Alvar J, Medrano F.J, Portus M, et al. Leishmania/HIV co-infection, South Western Europe 1990- 98. WHO/LEISH/2000.42. World Health Organization, Geneva.
- Pintado V, Martin-Rabadan P, Rivera ML, Moreno S, Bouza E. Visceral leishmaniasis in human immunodeficiency virus (HIV) – infected and non-HIV-infected patients. A comparative study. Medicine 2001; 80: 54-73.
- Shafiei R, Mohebali M, Akhoundi B, Galian MS, Kalantar F, Ashkan S, et al. Emergence of co-infection of visceral leishmaniasis in HIV-positive patients in northeast Iran: a preliminary study. Travel Med Infect Dis. 2014;12(2):173-8.
- World Heath Organization. Manual on Case Management and Surveillance of the Leishmaniases in the WHO European Region. Geneva: WHO; 2017.
- Akgül Ö, Kart Yaşar K, Sapmaz B, Kırkoyun Uysal H, Yıldırmak T, Şimşek F, et al. İzlemdeki hıv /aıds olgularındaki intestinal parazitlerin konvansiyonel ve moleküler yöntemler ile saptanması [Detection of intestinal parasites with conventional and molecular methods in follow-up HIV/AIDS cases]. Mikrobiyol Bul. 2018;52(3):273-283.
- Uysal HK, Adas GT, Atalik K, Altiparmak S, Akgul O, Saribas S, et al. The Prevalence of Cyclospora cayetanensis and Cryptosporidium spp. in Turkish patients infected with HIV-1. Acta Parasitol. 2017;6;62(3):557-564.
Investigation of Visceral Leishmaniasis and Coinfection of Intestinal Parasites in HIV-Positive Patients
Öz
Objective: Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV).
Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral
leishmaniasis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/Acquired Immune Deficiency Syndrome (AIDS) cases,
most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis,
cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups.
Materials and Methods: In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by
conventional methods in fecal samples from HIV-positive cases.
Results: 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal
samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests
yielded a positive band.
Conclusion: The regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region
was found to be low and VL was not detected.
Anahtar Kelimeler
Destekleyen Kurum
Hatay Mustafa Kemal University Scientific Research Projects Coordination Unit
Proje Numarası
Project number: 19.M.014
Kaynakça
- UNAIDS, Global HIV & AIDS statistics — 2018 fact sheet
- Markell EK, John DT, Krotoski WA. Medical Parasitology. Eighth edition, Pennsylvania: W.B. Saunders Comp, 1999:389-402
- Koch KL, Phillips DJ, Aber RC, Current WL. Cryptosporidiosis in hospital personel: Evidence for person to person transmission. Ann Intern Med 1985;102:593-596.
- Istre GR, Kreiss K, Hopkins RS, Healy GR, Benziger M, Canfield TM, et al. An outbreak of amebiasis spread by colonic irrigation at a chiropractic clinic. N Engl J Med. 1982 Aug 5;307(6):339-342.
- Sia IG, Paya CV. Renal transplantation. Infectious complications following renal transplantation.Surgical Clinics of North America 1998;78:95-114.
- Alvar J, Aparicio P, Aseffa A, Den Boer M, Canavate C, Dedet JP, et al. The relationship between leishmaniasis and AIDS: the second 10 years. Clin Microbiol Rev 2008;21(2): 334e59.
- Alvar J, Canavate C, Gutierrez-Solar B, Jimenez M, Laguna F, Lopez-Velez R, et al. Leishmania and human immunodeficiency virus coinfection: the first 10 years. Clin Microbiol Rev 1997;10(2):298e319.
- Cruz I, Nieto J, Moreno J, Canavate C, Desjeux P, Alvar J. Leishmania/HIV co-infections in the second decade. Indian J Med Res 2006;123(3):357e88
- Jarvis JN, Lockwood DN.Clinical aspects of visceral leishmaniasis in HIV infection.Curr Opin Infect Dis. 2013;26(1):1-9.
- ter Horst R, Collin SM, Ritmeijer K, Bogale A, Davidson RN. Concordant HIV infection and visceral leishmaniasis in Ethiopia: the influence of antiretroviral treatment and other factors on outcome.Clin Infect Dis. 2008;46(11)
- del Giudice P, Mary-Krause M, Pradier C, Grabar S, Dellamonica P, Marty P, et al. Impact of highly active antiretroviral therapy on the incidence of visceral leishmaniasis in a French cohort of patients infected with human immunodeficiency virus. J Infect Dis 2002;186:1366e70.
- Cota GF, de Sousa MR, Rabello A. Predictors of visceral leishmaniasis relapse in HIV-infected patients: a systematic review. PLoS Negl Trop Dis. 2011;5(6):e1153.
- Redhu NS, Dey A, Balooni V, Singh S. Leishmania-HIV coinfection: an emerging problem in India. AIDS 2006 May 12; 20(8):1213e5.
- Sinha PK, Rabidas VN, Pandey K, Verma N, Gupta AK, Ranjan A, et al. Visceral leishmaniasis and HIV coinfection in Bihar, India. J Acquir Immune Defic Syndr 2003;32(1):115e6.
- Acıpayam C, Çulha G, Altunay A, Akğlu F, Yeral A, Gülkan B. Treatment expreience with liposamal amphotericin B in pediatric patients with kala-azar. Abant Med J 2015;4(3):222-229.
- Ozkan AT, Yalçinkaya T, Kiliç S, Babür C, Schallig HD. HIV/ AIDS hastalarinda Leishmania infantum seropozitifliğinin araştirilmasi [Investigation of Leishmania infantum seropositivity in HIV/AIDS patients]. Mikrobiyol Bul. 2008 Jan;42(1):113-7. Turkish. PMID: 18444568.
- Köse H, Temoçin F. Evaluation of Adult Cases of Visceral Leishmaniasis Reported in Turkey by Pool Analysis Method. Klimik Dergisi. 2020; 33(2): 157-62.
- Desjeux P, Alvar J. Leishmania/HIV co-infections: epidemiology in Europe. Ann Trop Med Parasitol 2003; 1: 3-5.
- Desjeux P, Meert JP, Piot B, Alvar J, Medrano F.J, Portus M, et al. Leishmania/HIV co-infection, South Western Europe 1990- 98. WHO/LEISH/2000.42. World Health Organization, Geneva.
- Pintado V, Martin-Rabadan P, Rivera ML, Moreno S, Bouza E. Visceral leishmaniasis in human immunodeficiency virus (HIV) – infected and non-HIV-infected patients. A comparative study. Medicine 2001; 80: 54-73.
- Shafiei R, Mohebali M, Akhoundi B, Galian MS, Kalantar F, Ashkan S, et al. Emergence of co-infection of visceral leishmaniasis in HIV-positive patients in northeast Iran: a preliminary study. Travel Med Infect Dis. 2014;12(2):173-8.
- World Heath Organization. Manual on Case Management and Surveillance of the Leishmaniases in the WHO European Region. Geneva: WHO; 2017.
- Akgül Ö, Kart Yaşar K, Sapmaz B, Kırkoyun Uysal H, Yıldırmak T, Şimşek F, et al. İzlemdeki hıv /aıds olgularındaki intestinal parazitlerin konvansiyonel ve moleküler yöntemler ile saptanması [Detection of intestinal parasites with conventional and molecular methods in follow-up HIV/AIDS cases]. Mikrobiyol Bul. 2018;52(3):273-283.
- Uysal HK, Adas GT, Atalik K, Altiparmak S, Akgul O, Saribas S, et al. The Prevalence of Cyclospora cayetanensis and Cryptosporidium spp. in Turkish patients infected with HIV-1. Acta Parasitol. 2017;6;62(3):557-564.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Proje Numarası | Project number: 19.M.014 |
| Erken Görünüm Tarihi | 28 Mart 2024 |
| Yayımlanma Tarihi | 28 Mart 2024 |
| Gönderilme Tarihi | 1 Ekim 2022 |
| Kabul Tarihi | 21 Kasım 2022 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 19 Sayı: 1 |
