Detection of cryptosporidium parvum in HIV/aids patients by using various methods a descriptive cross-sectional study

Research Article
*Sandhya Papabathini, Rajeshwari Surpur, Venkatesh Naik, Ravivarma Vadegar and Shaik Gajani Mohammad
HIV/AIDS patients, Cryptosporidium parvum, Modified ZN staining, ELISA, Immunofluorescent Microscopy.

Background: Cryptosporidium parvum is one of the most important enteric opportunistic parasitic infections in immunocompromised patients. Cryptosporidium parvum is a coccidian protozoal parasite that inhabits the brush border of enterocytes, damages the epithelial cells and causes diarrhoeal disease. It causes severe and prolonged diarrhoea in HIV sero-positive/AIDS patients with CD4counts 200 cells/cumm. Early detection of cryptosporidium will enable the clinician in effective management of the disease. Various techniques based on different principles are available for the diagnosis of cryptosporidiosis. Aims and Objectives: This study was aimed to determine the incidence of cryptosporidial infection in HIV sero- positive/AIDS patients both with diarrhoea as well as without diarrhoea, to evaluate various methods of detection of C.parvum and correlate the CD4 counts with the incidence of cryptosporidiosis. Materials and methods Stool samples were collected from 110 HIV positive patients presenting with and without diarrhoea at RIMS, Raichur after obtaining informed consent. Each stool sample was divided into four parts and subjected to modified Ziehl Neelsen staining method, immunofluorescent microscopy, ELISA. Results: Out of 110 cases studied, 65 patients presented with diarrhoea and the remaining 45 were without diarrhoea. The major group affected was 31- 40 years with mean age 34.4 years. Male preponderance was seen. Out of 110 patients, 80 (73%) patients had CD4 count less than 200 cells/cumm. Maximum positivity was detected by ELISA i.e. 95.4% followed by Immunofluorescent Microscopy 92.6%, Modified ZN staining 77.3%. Conclusion: Our study highlights the importance of routine examination of stool samples for cryptosporidium oocysts in all HIV sero-positive /AIDS patients, irrespective of gastrointestinal symptoms. ELISA was found to be the most reliable method for diagnosis.