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. 2019 Feb 11:47:14.
doi: 10.1186/s41182-019-0142-0. eCollection 2019.

Intestinal helminth infections in HIV-infected patients in Savannakhet after establishment of an HIV registration network in Lao People's Democratic Republic

Yukako Kaneshiro  1 , Khamphang Sourinphoumy  2 , Naoki Imaizumi  3 , Mangkhalar Rasaphon  2 , Megumi Kuba-Miyara  1 , Shugo Sakihama  4 , Carmina Louise Hugo Guerrero  1 , Ketsaphone Nhativong  5 , Daisuke Nonaka  6 , Tiengkham Pongvongsa  5 , Jun Kobayashi  6 , Sengchanh Kounnavong  7 , Takuya Fukushima  1
Affiliations

Intestinal helminth infections in HIV-infected patients in Savannakhet after establishment of an HIV registration network in Lao People's Democratic Republic

Yukako Kaneshiro et al. Trop Med Health. .

Abstract

Background: In Lao People's Democratic Republic (PDR), which borders China, Vietnam, Cambodia, Thailand, and Myanmar, the number of HIV-infected patients has increased in recent years. HIV-infected patients diagnosed in Lao PDR are enrolled in a registration network and receive antiretroviral therapy (ART) covered by governmental financial support. Based on the registration network, we investigated intestinal helminth infections and coinfection with HTLV-1 in HIV-infected patients treated with an early intervention using ART in Lao PDR.

Methods: This cross-sectional study of all 252 HIV-infected patients at Savannakhet Provincial Hospital, located in the southern part of Lao PDR, was conducted between February and March 2018. Socioepidemiological information and clinical information were collected from a registration network database and by questionnaire administered to participants. Microscopic examination of intestinal helminth infections in stool samples and particle agglutination for anti-HTLV-1 antibody in plasma were performed.

Results: The median age of all 252 participants was 39 years old (range, 18-59). Based on the registration network database, there were 156 (61.9%) HIV-infected patients with a CD4-positive cell count ≥ 200 cells/μL and 146 (57.9%) with an HIV viral load < 250 copies/mL. Among 212 stool samples, 75 (35.4%) were found to contain one or more intestinal helminth species, including Opisthorchis viverrini (16.5%), Strongyloides stercoralis (10.8%), hookworm (10.4%), and Taenia saginata (3.3%). This rate of intestinal helminth infections was lower than that of a previous report conducted before the establishment of the registration network for HIV-infected patients in Lao PDR. There was no significant association between intestinal helminth infections and a lower CD4-positive T cell count or higher HIV viral load. HIV-infected patients with anti-HTLV-1 antibody positivity were not found in this cohort.

Conclusion: The registration network and an early intervention using ART may provide good medical care and improve the clinical course of HIV-infected patients in Lao PDR. However, the incidence of intestinal helminth infections remains high at 35.4%. The development of a specific medical care system for helminth infection for HIV-infected patients is necessary.

Keywords: Helminth infections; Human T cell leukemia virus type I; Human immunodeficiency virus; Lao People’s Democratic Republic; Registration network.

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Conflict of interest statement

This study was approved by the National Ethics Committee for Health Research, Ministry of Health, Lao PDR (no. 2017. 88. MC) and the Ethics Committee of the University of the Ryukyus, Japan (No. 169). Before starting the survey, surveyors explained to the participants the details of this study, such as its purpose, voluntary participation, information that would be collected, and how to keep and manage the data. Written informed consent was obtained from each respondent.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Location of Savannakhet Province (black) in Laos
Fig. 2
Fig. 2
Workflow of this study
See this image and copyright information in PMC

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