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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 91, Num. 6, 1996
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Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 91(6),Nov./Dec.
1996,
RESEARCH NOTE
Intestinal Parasites in AIDS and +HIV Patients in
Uberlandia,Minas Gerais, Brazil
Julia Maria Costa-Cruz/+, Marcelo Simao Ferreira*,
IrisRicardo Rossin++
Departamento de Patologia *Departamento de Clinica
Medica,Centro de Ciencias Biomedicas, Universidade Federalde
Uberlandia, Av. Para 1720, 38400-902 Uberlandia,MG, Brasil
+Corresponding author. Fax: +55-34-218.2333
++Bolsista PET/CAPES/Medicina/UFU
Received 26 February 1996, Accepted 16 August 1996
Key words: intestinal parasites - Acquired Immunodeficiency
Syndrome- Human Immunodeficiency Virus
Code Number: OC96122
Sizes of Files:
Text: 10.0K
Graphics: No associated graphics files
In spite of biomedical advances, parasitic disease continues
to exist and represent an exemple of complex interaction
between parasite and host (OPAS 1985, publicacion 1). Many
patients infected by the Human Immunodeficiency Virus (HIV)
because of their sexual practices, are predisposed to enteric
infections as well as to traditional sexually transmitted
diseases (SC Phillips et al. 1981 N Engl J Med 305:
603-606). Intestinal parasites in HIV infected patients, have
been reported mainly in USA and Africa (PD Smith et al.
1988 Am Inter Med 108: 328-333, BE Laughon et al. 1988
Gastroenterol 94: 984-993, MA Gomez Moraes et al. 1995
Trop Med Parasitol 46: 109-114).
In Brazil, the occurence of intestinal parasites in HIV
patients was reported particullarly in the states of Rio de
Janeiro and Sao Paulo (JR Coura 1987 J Bras Med 53:
42-54, RMDS Dias et al. 1988 Rev Inst Adolfo Lutz 48:
63-67, H Moura et al. 1989 Mem Inst Oswaldo Cruz 84:
527-533, RMDS Dias et al. 1992 Rev Inst Med Trop Sao Paulo
34: 15-17).
This study was undertaken to contribute to the knowledge of
the occurence of intestinal parasites in AIDS and +HIV
patients in Uberlandia, in the State of Minas Gerais,
Southeast region of Brazil. A retrospective analysis of
medical files was made of 291 patients who were attended in
the Infirmary of Infectious and Parasitic Diseases of the
Clinical Hospital at Federal University of Uberlandia
(HC-UFU), during the period of January 1990 to December 1994.
Of these patients 238 were AIDS patients and 53 were +HIV.
Files of attended patients (897) were analized as a control
group in the Clinical Medical Ambulatory of HC-UFU and all
these patients did parasitologic examination in feces in the
same period. The data was randomally considering the total
number of patients month by month during the work period. The
results were obtained through the examination of feces and
submitted to statistic analisys following a normal
distribution curve. The group of AIDS patients was compared to
the +HIV and control group adopting a level of alfa
significance equal to 0.05 (5%).
The fecal material of the 1,188 patients was collected in
plastic flask, containing 10ml of MIF, for the realization of
the method of MIFC. In the cases of 108 patients with AIDS and
diarrheic feces, 10ml of formol 40%, was also used to research
of Cryptosporidium sp. or Isospora belli by
Kinyoun coloration. The methods of MIFC and coloration were
both made in the laboratory of clinical analysis of HC-UFU
(Baermman-Moraes method is not a routine in this
laboratory).
As result of this research 39 (16.4%) patients were diagnosed
with parasites in the AIDS group; of these, 78.9% were male
and 21.1% were female. Their ages varied between 4 and 60
years; 94.7% were from the State of Minas Gerais and 5.3% from
the State of Sao Paulo.
In the group of +HIV patients there were 5 (9.4%) patients
with parasites; 80% were male and 20% female. Their ages
varied between 22 and 33 years; 80% were from the State of
Minas Gerais and 20% from the State of Sao Paulo.
In the control group there were 69 (7.7%) patients with
parasites; 58.7% were male and 41.3% were female. Their ages
varied between 1 and 76 years; 90.6% were from the State of
Minas Gerais, 6.7% from the State of Sao Paulo and 2.7% from
the State of Goias.
The Table shows the occurrence of intestinal parasites
detected by the method of MIFC or Kinyoun in AIDS, +HIV
patients and control group.
In the AIDS patients group there were 32 (82.1%) cases of
monoparasitism, 5 (12.8%) cases of biparasitism and 2 (5.1%)
cases of polipara-sitism. The associations found are the
following: Strongyloides stercoralis and Hymenolepis
nana (1 case), S. stercoralis and Giardia
intestinalis (1 case), S. stercoralis and
Cryptosporidium sp. (1 case), Ascaris lumbricoides
and Cryptosporidium sp. (1 case), A.
lumbricoides and hookworm (1 case), Cryptosporidium
sp., hookworm and Entamoeba histolytica
(1case) and S. stercoralis, hookworm, E.
histolytica and Trichuris trichiura (1 case).
In the +HIV patients group there were 5 cases of
monoparasitism. In the control group there were 65 (94.2%)
cases of monoparasitism, 3 (4.3%) cases of biparasitism and 1
case (1.5%) of poliparasitism. The associations found were:
G. intestinalis and H. nana (2 cases), hookworm
and S. stercoralis (1 case) and T. trichiura, A.
lumbricoides and S. stercoralis (1 case).
The statistical analysis showed significance when compared the
occurrence of S. stercoralis in AIDS patients group and
in the control group (calculated Z = 2.71 to
critical Z = 1.645). The differences for the rest of
the parasites were not significant in comparison to the
control group.There were no significant statistical difference
in comparison to the +HIV group of patients.
A significant statistical difference was observed in
comparison to the number of patients with more than one
parasite in reference to the group of patients with AIDS and
in the control group (calculated Z = 3.92 to critical
Z = 1.645).
It was demonstrated that the occurrence of intestinal
parasitic diseases in AIDS patients was higher than the
observed in +HIV patients and the control group. This
difference was significant when compared to the occurrence of
S. stercoralis in AIDS group and control group. It was
also observed that patients with more than one parasite are
more frequently encountered among AIDS individuals, the
difference is significant in relation to the control group.
The importance of research in Cryptosporidium sp.
should be emphasized as well as the routine diagnosis in
patients that reveal diarrhea. The frequency of S.
stercoralis is also important, even though the specific
parasitologic method for research in helminths larvae in feces
were not used in the routine of the laboratory.
Acknowledgements: to Vanderli Anacleto de Campos (Dept.
of Mathematics at Educational Fundation of Ituiutaba) for
stastistical assistence, Ademir Barsanulfo de Moraes, chief of
the Laboratory of Clinical Analysis, Clinical Hospital,
Federal University of Uberlandia, and Maria da Consolacao
Nogueirade Souza for technical assistance.
TABLE: Intestinal parasites in AIDS, +HIV patients and control
groupin Uberlandia, MG, Brazil
AIDS
--------------------------
Parasites Frequences no. positive/
no. tested
---------------------------------------------------
Cryptosporidium sp. 13.0% (15/108)
Strongyloides stercoralis 3.8% (09/238)
Giardia intestinalis 3.4% (08/238)
Isospora belli 2.8% (03/108)
Entamoeba histolytica 2.1% (05/238)
Hookworm 2.1% (05/238)
Ascaris lumbricoides 0.8% (02/238)
Hymenolepis nana 0.4% (01/238)
Schistosoma mansoni 0.4% (01/238)
Trichuris trichiura 0.4% (01/238)
Enterobius vermicularis 0 (00/238)
Table continued
+HIV
------------------------
Parasites Frequences no. positive/
no. tested
--------------------------------------------------
Cryptosporidium sp. ---- ----
Strongyloides stercoralis 3.8% (02/53)
Giardia intestinalis 1.9% (01/53)
Isospora belli ---- ----
Entamoeba histolytica 1.9% (01/53)
Hookworm 1.9% (01/53)
Ascaris lumbricoides 0 (00/53)
Hymenolepis nana 0 (00/53)
Schistosoma mansoni 0 (00/53)
Trichuris trichiura 0 (00/53)
Enterobius vermicularis 0 (00/53)
Table continued
Control group
------------------------
Parasites Frequences no. positive/
no. tested
--------------------------------------------
Cryptosporidium sp. ---- ----
Strongyloides stercoralis 1.2% (11/897)
Giardia intestinalis 3.8% (34/897)
Isospora belli ---- ----
Entamoeba histolytica 0.9% (08/897)
Hookworm 1.3% (12/897)
Ascaris lumbricoides 0.5% (05/897)
Hymenolepis nana 0.4% (04/897)
Schistosoma mansoni 0.2% (02/897)
Trichuris trichiura 0.5% (05/897)
Enterobius vermicularis 0.2% (02/897)
---- = not tested
Copyright 1996 Fundacao Oswaldo Cruz
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