Revista de SIDA e investigación clínica

Mycobacterium tuberculosis as a Common Cause of Diarrhea in AIDS Patients

Abstract

Behera MK, Nath P and Meher LK

Background: Gastrointestinal infections in human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) patients are a significant cause of morbidity and mortality, affecting up to 90% patients with varied pattern of etiology across the globe.

Aim: The present study was conducted to determine the prevalence and microbiological profile of pathogens associated with diarrhea in HIV positive patients in Eastern India and their relation to CD4 counts.

Methods: This was a case-controlled study with consecutive HIV cases attending ART clinic from August 2014 to June 2017 with diarrhea taken as cases and one hundred age sex matched HIV negative population with diarrhea in the same period as controls. All patients were evaluated with stool routine and microscopic examination with all standard stains and transabdominal ultrasound. Patients with persistent diarrhea were subjected ileocolonoscopy with biopsy and culture for Mycobacterium tuberculosis. Statistical analysis was done by using SPSS software 16.

Results: A total of 226 subjects were enrolled (126 cases and 100 controls). Mean age nad male to female ratio of cases were 30.19 ± 7.127, 2.5:1 and that of controls were 28.32 ± 9.63, 1.8:1 respectively. The most common enteric pathogen detected in HIV positive diarrhea subjects was Mycobacterium tuberculosis [41 cases (32.53%)] followed by Isospora belli 21.49%) and Cryptosporidum parvum (11.9%). Among diarrheal stool samples with Mycobacterium tuberculosis, 73.3% cases had CD4 <200, 23.3% cases had CD4 200-350 and 3.33% case had CD4 >350 (p-value >0.05). All cases of Isosporiasis had CD4 <200 and 80% cases of Cryptosporidiosis had CD4 <200 and 20% had CD4 within 200-350. Correlation between Isospora&Cryptosporidiumwith CD4 count was significant (P<0.05).

Conclusion: Mycobacterium tuberculosis was the most commonly isolated pathogen in HIV associated diarrhea followed by Isosporaand Cryptosporidium.