Immunological Responses of Hiv Sero-Positive with and Without Tuberclosis Candidiasis and Some Selected Opportunistic Intestinal Parasitic Diseases Butajira General Hospital, Gurage Zone, Southern Ethiopia

Immunological Responses of Hiv Sero-Positive with and Without Tuberclosis Candidiasis and Some Selected Opportunistic Intestinal Parasitic Diseases Butajira General Hospital, Gurage Zone, Southern Ethiopia

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Title: Immunological Responses of Hiv Sero-Positive with and Without Tuberclosis Candidiasis and Some Selected Opportunistic Intestinal Parasitic Diseases Butajira General Hospital, Gurage Zone, Southern Ethiopia
Author: Melesachew, Argaw; Dr. Sissay, Menkir
Abstract: Human immunodeficiency virus (HIV) pandemic is among the greatest health crises ever faced by humanity. Morbidity and mortality in HIV disease is due to immune suppression leading to life-threatening opportunistic infections (OIs) during the natural course of the disease. However, information available on the effect OIs and coinfections on the immunological responses of HIV sero-positive individuals is limited. This study was aimed at describing the immunological responses of HIV sero-positive individuals with and without tuberculosis, candidiasis and some selected opportunistic intestinal parasitic diseases in Butajira General Hospital. A cross sectional survey involving 384 study participants who were selected using serial sampling method was conducted from March – June 2014 to determine the prevalence of OIs and to correlate CD4+T-cell counts with the prevalence of OIs among HIV-infected individuals. Clinical observation, laboratory and microbiological analysis were used for identification of the infections in the patients. Socio-demographic and clinical data of the patients were collected using questionnaire. For the diagnosis of the selected opportunistic infections, laboratory examination techniques such as direct wet mount technique, concentration technique, modified Ziehl-Neelsen method, sputum smear microscopy, and KOH test were used. CD4+ T-cell counts of participants were determined using flow cytometry technique. Analysis of the results was done using SPSS version 20 statistical software and Spearman coefficient of correlation, chi-square and odds ratio were used as the measure of association. P-value less than 0.05 was considered statistically significant for all test. Out of 384 HIV sero-positive individuals involved in this research 206(53.6%) were females and 178(46.4%) were males. The mean age of the study group was 34.11+ 10.09 standard deviation and the range was 61-13 years. From the total studied HIV sero-positive individuals, 202 (99 Male and 103 Female) did not start ART services and the remains 182 (79 Male and 103 Female) had started receiving ART services. The prevalence of cryptosporidiosis, isosporidiasis, microsporidiosis, tuberculosis, oral candidiaisis; and tuberculosis and oral candidiaisis together among the patients were 16(4.2%), 19(4.9%), 4(1.0%), 80(20.8%) 73(19.0%) and 81(21.1%), respectively. In this study, TB and oral candidiasis was observed in HIV sero-positive participants even in the individuals who had a higher CD4+T-cell count of 350 cells /mm3. In all age groups, the mean CD4+T-cell counts of the studied HIV sero-positive individuals who had and had not started ART services had been much more greater (P < 0.05) than the mean CD4+T-cell counts of those HIV sero-positive individuals who had the opportunistic bacterial, fungal and parasitic diseases. Overall, the prevalence of the opportunistic diseases was significantly (P < 0.05) associated with the immune suppression (with respect to CD4+T-cell decline) of the patients. Thus, opportunistic diseases such as cryptosporidiosis, isosporidiasis, microsporidiosis, tuberculosis and oral candidiaisis play a role in the immune suppression of patients. Therefore, interventions need to be designed to promote early HIV testing; early testing of any opportunistic infections in the patient and early enrollment of HIV infected individuals with and without any opportunistic infections into ART services. Initiation of ART before the CD4+T-cell count drops below 350 should be encouraged.
Description: 110p.
URI: http://hdl.handle.net/123456789/3254
Date: 2015-01


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