A cross-sectional serological study of cysticercosis,schistosomiasis, toxocariasis and echinococcosis in HIV-1 infected people in Beira, Mozambique

Abstract

Background:Helminthic infections are highly endemic in Mozambique, due to limited access to healthcare and resourcesfor disease prevention. Data on the subclinical prevalence of these diseases are scarce due to the fact that an immunologicaland imaging diagnosis is not often available in endemic areas. We conducted a cross-sectional study on HIV1+patientsfrom Beira city in order to determine the seroprevalence of cysticercosis, schistosomiasis, toxocariasis and echinoccocosisand its possible interaction with HIV infection.Methodology/PrincipalFindings:Patients (601) were voluntarily recruited at the Ponta Gea Health Center and theirdemographic and clinical data were recorded (including CD4+cell count and antiretroviral regimen). Mean age was 39.7years, 378 (62.9%) were women and 223 (37.1%) were men. Four hundred seventy-five (475) patients (79%) were already onhighly active antiretroviral therapy (HAART), and 90 started therapy after being enrolled in the study. For serological testingwe used a Multiplex Western Blot IgG from LDBIO Diagnostics. The overall seroprevalence was 10.2% for cysticercosis, 23%for schistosomiasis, 7.3% for toxocariasis and 17.3% for echinococcosis.Conclusions/Significance:Neither age nor the CD4+count were significantly associated with the seroprevalence of thehelminths studied. However, patients with CD4+between 200–500/ml had a higher seroprevalence to all helminths thanthose with less than 200/ml cells/and those with more than 500 cells/ml. Female gender was significantly associated withcysticercosis and schistosomiasis, and being in HAART with toxocariasis. Headache was significantly associated withcysticercosis and toxocariasis. There was no association between epilepsy and seropositivity to any of the parasites. Thestudy concluded that a clear understanding of the prevalence and manifestations of these coinfections, how best todiagnose subclinical cases, and how to manage diseases with concomitant antiretroviral therapy is needed.