Background: In immunocompromised human immunodeficiency virus (HIV) infected patients,
opportunistic parasites and H. pylori are a major public health concern. In Egypt, few data regarding the
problem magnitude and risk variables emerge from settings with scarce resources.
Objective: The goal of this study was to determine detection rates of intestinal parasitic co-infections with
H. pylori in HIV patients, as well as to record co-infection risk and predictors.
Subjects and Methods: From Suez Fever Hospital, single fecal samples were collected from 70 HIV
patients to detect intestinal parasitic infections. Stool samples were examined microscopically, fresh with
iodine and acid-fast stain. Molecular diagnosis for H. pylori and Cryptosporidium spp. was performed
using nested-PCR technique. Risk factors for H. pylori and parasites co-infection among HIV patients were
assessed by a comprehensive behavioral questionnaire that included demographics data and clinical
history.
Results: Intestinal parasites (IP) were detected in 74.3% of the total study population. Pathogenic parasites
identified were Cryptosporidium spp., E. histolytica/E. dispar complex, and G. lamblia in 28.5%, 27.1%,
and 22.8%, respectively. Molecularly, H. pylori was detected in 15/70 (21.4%) of HIV patients of which H.
pylori co-existed with Cryptosporidium spp. in seven patients (46.66%), and with I. belli in two patients
(13.33%). Statistically, there was a strong positive correlation between cryptosporidiosis and diarrhea, as
well as between infection with I. belli and diarrhea. Co-infection of H. pylori with Cryptosporidium spp., or
I. belli was statistically linked to abdominal pain and diarrhea. Gender showed a statistically significant
association with both Cryptosporidium and I. belli infections.
Conclusion: It was concluded that HIV-positive patients with diarrhea were more likely to additionally
suffer from Cryptosporidium spp. and H. pylori. The co-occurrence of Cryptosporidium spp. and H. pylori
supports the theory of co-infection.