Epidemiological and immunological studies of HIV seropositive patients infected with Cryptosporidium at Kuala Lumpur Hospital, Malaysia

Mohamed Kamel Abdul Ghani, Sugathathissa, A. Norazah, H. Lokman, A. Nasuruddin, L. Christopher

Research output: Contribution to journalArticle

Abstract

Objective: A study of HIV seropositive patients infected with Cryptosporidium was conducted at the Kuala Lumpur Hospital between August 1996-January 1997 to ascertain their epidemiological and immunological relationship. Design: 100 HIV seropositive patients were recruited for this study and they were classified to their clinical status using CDC classification system. They were also divided into 3 groups by their CD4 lymphocyte percentage; CD4 < 14%, 14%-28% and ≥ 29%. Materials and Methods: Patients were required to submit a Fresh stool sample which was then fixed in 10% formalin and concentrated using the formalin-ether technique from which air dried thin smears were stained with flourescein-labelled monoclonal, Crypto-cel IF Test® (and auramine phenol to detect the presence of Cryptosporidium oocysts. Results: The results showed that 9% of the patients screened, were found to be excreting Cryptosporidium oocysts using the flourescein-labelled monoclonal Crypta-cel IF test and auramine phenol staining. All 9 cases were identified among patients from 30-39 years of age. Five (11.4%) of them were AIDS patients, 3 (7.9%) were symptomatic and one (5.6%) was asymptomatic. It was also noted that patients with CD4 cell counts < 14% formed the majority of those infected with Cryptosporidium; 15.4% of the patients with CD4 cell counts < 14% were infected with Cryptosporidium, whereas only 6% of those with CD4 cell counts of 14-28% were infected. None of the patients with CD4 cell counts ≥ 29% had Cryptosporidium in their stool samples. Conclusion: HIV seropositive patients are at risk of Cryptosporidium infection especially those whose immunological status are very poor. Although not statistically significant, patients with CD4 cell counts < 14% were more commonly infected with Cryptosporidium than patients with CD4 cell counts > 29%. Because of the increasing importance of these coccidian organisms as enteric pathogen in AIDS patients, screening for Cryptosporidium should be routinely performed on patients with depressed CD4 cell counts or with diarrhoeic disease.

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalInternational Medical Journal
Volume6
Issue number3
Publication statusPublished - 1999

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Cryptosporidium
Malaysia
Epidemiologic Studies
HIV
Centers for Disease Control and Prevention (U.S.)
CD4 Lymphocyte Count
Acquired Immunodeficiency Syndrome
Lymphocytes

Keywords

  • Cryptosporidium
  • HIV seropositive
  • Immunity
  • Malaysia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Epidemiological and immunological studies of HIV seropositive patients infected with Cryptosporidium at Kuala Lumpur Hospital, Malaysia. / Abdul Ghani, Mohamed Kamel; Sugathathissa; Norazah, A.; Lokman, H.; Nasuruddin, A.; Christopher, L.

In: International Medical Journal, Vol. 6, No. 3, 1999, p. 207-210.

Research output: Contribution to journalArticle

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abstract = "Objective: A study of HIV seropositive patients infected with Cryptosporidium was conducted at the Kuala Lumpur Hospital between August 1996-January 1997 to ascertain their epidemiological and immunological relationship. Design: 100 HIV seropositive patients were recruited for this study and they were classified to their clinical status using CDC classification system. They were also divided into 3 groups by their CD4 lymphocyte percentage; CD4 < 14{\%}, 14{\%}-28{\%} and ≥ 29{\%}. Materials and Methods: Patients were required to submit a Fresh stool sample which was then fixed in 10{\%} formalin and concentrated using the formalin-ether technique from which air dried thin smears were stained with flourescein-labelled monoclonal, Crypto-cel IF Test{\circledR} (and auramine phenol to detect the presence of Cryptosporidium oocysts. Results: The results showed that 9{\%} of the patients screened, were found to be excreting Cryptosporidium oocysts using the flourescein-labelled monoclonal Crypta-cel IF test and auramine phenol staining. All 9 cases were identified among patients from 30-39 years of age. Five (11.4{\%}) of them were AIDS patients, 3 (7.9{\%}) were symptomatic and one (5.6{\%}) was asymptomatic. It was also noted that patients with CD4 cell counts < 14{\%} formed the majority of those infected with Cryptosporidium; 15.4{\%} of the patients with CD4 cell counts < 14{\%} were infected with Cryptosporidium, whereas only 6{\%} of those with CD4 cell counts of 14-28{\%} were infected. None of the patients with CD4 cell counts ≥ 29{\%} had Cryptosporidium in their stool samples. Conclusion: HIV seropositive patients are at risk of Cryptosporidium infection especially those whose immunological status are very poor. Although not statistically significant, patients with CD4 cell counts < 14{\%} were more commonly infected with Cryptosporidium than patients with CD4 cell counts > 29{\%}. Because of the increasing importance of these coccidian organisms as enteric pathogen in AIDS patients, screening for Cryptosporidium should be routinely performed on patients with depressed CD4 cell counts or with diarrhoeic disease.",
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AU - Lokman, H.

AU - Nasuruddin, A.

AU - Christopher, L.

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N2 - Objective: A study of HIV seropositive patients infected with Cryptosporidium was conducted at the Kuala Lumpur Hospital between August 1996-January 1997 to ascertain their epidemiological and immunological relationship. Design: 100 HIV seropositive patients were recruited for this study and they were classified to their clinical status using CDC classification system. They were also divided into 3 groups by their CD4 lymphocyte percentage; CD4 < 14%, 14%-28% and ≥ 29%. Materials and Methods: Patients were required to submit a Fresh stool sample which was then fixed in 10% formalin and concentrated using the formalin-ether technique from which air dried thin smears were stained with flourescein-labelled monoclonal, Crypto-cel IF Test® (and auramine phenol to detect the presence of Cryptosporidium oocysts. Results: The results showed that 9% of the patients screened, were found to be excreting Cryptosporidium oocysts using the flourescein-labelled monoclonal Crypta-cel IF test and auramine phenol staining. All 9 cases were identified among patients from 30-39 years of age. Five (11.4%) of them were AIDS patients, 3 (7.9%) were symptomatic and one (5.6%) was asymptomatic. It was also noted that patients with CD4 cell counts < 14% formed the majority of those infected with Cryptosporidium; 15.4% of the patients with CD4 cell counts < 14% were infected with Cryptosporidium, whereas only 6% of those with CD4 cell counts of 14-28% were infected. None of the patients with CD4 cell counts ≥ 29% had Cryptosporidium in their stool samples. Conclusion: HIV seropositive patients are at risk of Cryptosporidium infection especially those whose immunological status are very poor. Although not statistically significant, patients with CD4 cell counts < 14% were more commonly infected with Cryptosporidium than patients with CD4 cell counts > 29%. Because of the increasing importance of these coccidian organisms as enteric pathogen in AIDS patients, screening for Cryptosporidium should be routinely performed on patients with depressed CD4 cell counts or with diarrhoeic disease.

AB - Objective: A study of HIV seropositive patients infected with Cryptosporidium was conducted at the Kuala Lumpur Hospital between August 1996-January 1997 to ascertain their epidemiological and immunological relationship. Design: 100 HIV seropositive patients were recruited for this study and they were classified to their clinical status using CDC classification system. They were also divided into 3 groups by their CD4 lymphocyte percentage; CD4 < 14%, 14%-28% and ≥ 29%. Materials and Methods: Patients were required to submit a Fresh stool sample which was then fixed in 10% formalin and concentrated using the formalin-ether technique from which air dried thin smears were stained with flourescein-labelled monoclonal, Crypto-cel IF Test® (and auramine phenol to detect the presence of Cryptosporidium oocysts. Results: The results showed that 9% of the patients screened, were found to be excreting Cryptosporidium oocysts using the flourescein-labelled monoclonal Crypta-cel IF test and auramine phenol staining. All 9 cases were identified among patients from 30-39 years of age. Five (11.4%) of them were AIDS patients, 3 (7.9%) were symptomatic and one (5.6%) was asymptomatic. It was also noted that patients with CD4 cell counts < 14% formed the majority of those infected with Cryptosporidium; 15.4% of the patients with CD4 cell counts < 14% were infected with Cryptosporidium, whereas only 6% of those with CD4 cell counts of 14-28% were infected. None of the patients with CD4 cell counts ≥ 29% had Cryptosporidium in their stool samples. Conclusion: HIV seropositive patients are at risk of Cryptosporidium infection especially those whose immunological status are very poor. Although not statistically significant, patients with CD4 cell counts < 14% were more commonly infected with Cryptosporidium than patients with CD4 cell counts > 29%. Because of the increasing importance of these coccidian organisms as enteric pathogen in AIDS patients, screening for Cryptosporidium should be routinely performed on patients with depressed CD4 cell counts or with diarrhoeic disease.

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