The epidemiological characteristics and influencing factors for Blastocystis hominis infection among human immunodeficiency virus seropositive individuals in Tengchong of Yunnan Province

Abstract

Abstract:

Objective To investigate the epidemiological characteristics, genotype distribution and influencing factors for Blastocystis hominis infection among human immunodeficiency virus （HIV） seropositive individuals in Tengchong of Yunnan Province, China. Methods In the cross-sectional survey, stool specimens from HIV-seropositive individuals were collected in a hospital in Tengchong City, and the small-subunit ribosomal RNA (SSU-RNA) of B. hominis was examined by PCR. The positive results were further verified by sequencing. The evolutionary tree was constructed to analyze genotype distribution. A structured questionnaire was applied to collect basic information. The influencing factors for co-infection with HIV and Blastocystis hominis were analyzed with the single-factor analysis and logistic regression analysis. Results A total of 324 stool specimens were collected. PCR results showed that 12 samples had a specific band of SSU-RNA for B. hominis at 1 100 bp, with a positive rate of 3.7% (12/324). The evolutionary tree showed that the B. hominis subtypes ST1 (n = 3, 25%), ST3 (n = 2, 16.7%), ST4 (n = 3, 25%), ST7 (n = 3, 25%), and ST12 (n = 1, 8.3%) were the main subtypes in the HIV-infected individuals. Single-factor analysis revealed that the type of tap water (χ² = 4.398, P < 0.05), livestock-raising (χ² = 7.448, P < 0.05), frequent contact with animals (χ² = 6.276, P < 0.05), CD4⁺ cell count (χ² = 4.414, P < 0.05), and HIV-RNA viral load (χ² = 11.829, P < 0.05) were influencing factors for B. hominis infection among HIV-seropositive individuals. Logistic regression model showed that drinking unboiled tap water (χ² = 6.595, P < 0.05), livestock-raising (χ² = 6.740, P < 0.059), CD4⁺ cell count ≤ 500 cells/μl (χ² = 3.864, P < 0.05), and an HIV-RNA viral load > 50 copies/ml(χ² = 9.561, P < 0.05) were the influencing factors for B. hominis infection among HIV-seropositive individuals. Conclusion The prevalence of B. hominis infection among HIV-seropositive individuals is 3.7% in Tengchong of Yunnan Province. The B. hominis mainly has five genotypes. The main influencing factors for B. hominis infection among HIV-seropositive individuals include drinking unboiled tap water, raising of livestock and low immune function.

Key words: HIV/AIDS, Blastocystis hominis, Genotype, Co-infection, Influence factor

CLC Number:

R382.9

Xue-jiao TENG, Yan-hong CHU, Cheng-cheng ZHAI, Ying-fang YU, Yu-chun CAI, Shao-hong CHEN, Lin AI, Li-guang TIAN, Jia-xu CHEN. The epidemiological characteristics and influencing factors for Blastocystis hominis infection among human immunodeficiency virus seropositive individuals in Tengchong of Yunnan Province[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2018, 36(2): 129-134.

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References 37

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因素 Factor		检查人数 No. exam′d	感染率/% Infection rate/%	OR (95%CI)	χ²值 χ² value	P值 P value
性别Gender	男 Male	157	1.9	0.342(0.091, 1.287)	2.745	0.098
性别Gender	女 Female	167	5.4	0.342(0.091, 1.287)
年龄Age	≤ 40	181	4.4	0.622(0.184, 2.110)	0.590	0.443
年龄Age	> 40	143	2.8	0.622(0.184, 2.110)
家庭总人口数 No. of family members	≤ 5	273	4.0	0.507(0.064, 4.018)	0.059	0.808
家庭总人口数 No. of family members	> 5	48	2.1	0.507(0.064, 4.018)
厕所类型 Type of toilets	旱厕Dry toilet	74	6.8	N/A	2.764	0.430
厕所类型 Type of toilets	粪池Spetic tank	112	3.6
	水冲厕Water flushing toilet	135	0
	公共厕所Public toilet	3	3.7
日常饮用水 Daily drinking water	开水Boiled water	303	3.0	0.184(0.046, 0.738)	4.398	0.036
日常饮用水 Daily drinking water	直接饮用自来水 Drinking-directly tap water	21	14.3	0.184(0.046, 0.738)
	水井水Well water	0	0
	桶装水Bottled water	0	0
饲养宠物 Keeping pets	是 Yes	81	4.9	1.526(0.447, 5.208)	0.434	0.510
饲养宠物 Keeping pets	否 No	243	3.3	1.526(0.447, 5.208)
饲养家畜 Raising livestock	是 Yes	172	6.4	10.317(1.316, 80.874)	7.448	0.006
饲养家畜 Raising livestock	否 No	152	0.7	10.317(1.316, 80.874)
经常接触动物 Having regular contactswith animals	是 Yes	183	6.0	8.953(1.142, 70.195)	6.276	0.012
经常接触动物 Having regular contactswith animals	否 No	141	0.7	8.953(1.142, 70.195)
CD4⁺ 细胞计数 CD4⁺ cell count	≤ 500	141	6.8	4.091(1.087, 15.403)	5.025	0.025
CD4⁺ 细胞计数 CD4⁺ cell count	> 500	181	1.6	4.091(1.087, 15.403)
贫血Anemia	是 Yes	9	11.1	3.455(0.397, 30.079)	0.957	0.328
贫血Anemia	否 No	315	3.5	3.455(0.397, 30.079)
HIV-RNA病毒载量 HIV-RNA viral load	≤ 50	294	2.4	8.200(2.425, 27.726)	11.829	0.001
HIV-RNA病毒载量 HIV-RNA viral load	> 50	30	16.7	8.200(2.425, 27.726)

因素Factor	回归系数b	标准误S.E	卡方值Wald	P值P value	OR	95%置信区间95%CI
日常饮用水 Daily drinking water	2.237	0.871	6.595	0.010	9.362	(1.698, 50.612)
饲养家畜 Raising livestock	2.830	1.090	6.740	0.009	16.944	(2.001, 143.498)
CD4⁺细胞计数 CD4⁺ cell count	1.431	0.728	3.863	0.049	4.181	(1.004, 17.413)
HIV-RNA病毒载量 HIV-RNA viral load	2.251	0.728	9.561	0.002	9.493	(2.280, 39.535)