Intestinal Parasitic Infections in Adult Living with HIV in Cochabamba, Bolivia

(eng) BACKGROUND: Thanks to the widespread use of Antiretroviral Therapy (ART), Human Immunodeficiency Virus (HIV) infection is becoming a chronic manageable disease. In low resources settings where ART is available, but not widely, opportunistic infections such as parasites diseases remain common. These conditions represent a public health problem in the world due to the high prevalence in developing countries and particularly for patients with HIV/AIDS. To date there have been no systematic study on the prevalence of intestinal parasites in people living with HIV/AIDS (PLWHIV) in Bolivia. The study aimed to evaluate the occurrence of intestinal parasitic infections in PLWHIV who attended routine controls at the reference center for HIV control and prevention in Cochabamba (CDVIR) between January 2011 and December 2015. METHODS: Ethical approval was obtained prior to the commencement of this study from the Ethics Committees of the Department of Cochabamba-Bolivia and the Universidad Mayor de San Simón, Institute of Biomedical Research (IIBISMED/UMSS). Code: CB-2016-015. A Retrospective Analysis was carried out Based on the reports of the reference laboratory in the city of Cochabamba (LABIMED) using direct parasitological methods founded on the macroscopic and microscopic identification of parasitic elements present in the stool. Data was collected in an Excel spreadsheet, based on reports from the parasitology laboratory, which was transferred for statistical analysis to SPSS 24.0 (SPSS Inc., Chicago IL, USA). The characteristics of the study participants are reported as mean, range and percentage, as appropriate. The test of X2 or Fisher’s exact test was used for all categorical variables. Logistic regression analysis was used to test the associations. A given statistical test was reported significant if it resulted in a p-value <0.05. RESULTS: During the 5-years of the study, a number varying between 313 and 620 patients were assessed each year, and 12 parasitic species were identified. The highest prevalence was 33.2% in 2011 and there was 9.9% of polyparasitism. In 2012, the prevalence was 28.6%, with 8.3% of polyparasitism, in 2013 it reached 30.4% with a polyparasitosis of 7.7%, while in 2014 it was 24. 5%, the lowest in the period, with a polyparasitism rate of 8.5%. Finally, in 2015 the prevalence reached 27.1% with a polyparasitism rate of 7.3%. The most prevalent species in order of frequency were Blastocystis Homminis, Entamoeba coli (non-Pathogen), Giardia Lamblia and Entamoeba histolytica/dispar, respectively. Regression analysis showed no significant association with sex or with consistence of stool sample but prevalence was higher in people under 30 years of age. CONCLUSION: Taking into account the epidemiological and geographical context, the frequency of presentation of these infections reach practically one third of these population and thus remains a high problem in Bolivia. So, further studies are required to clarify the epidemiology of these infectious diseases in this endemic region.