Prevalence and pattern of soil transmitted intestinal helminth infections amongst HIV infected children in a tertiary hospital south eastern, Nigeria

Abstract

Objective: Soil-transmitted helminth infections (STHI) coexist with human immunodeficiency virus (HIV) infection, and they are widespread in environments where poverty is endemic. Helminths upregulate immunological stimulation while HIV’s effect is down-regulatory, depicted by the increased incidence of hypersensitivity drug reactions in advanced HIV/AIDS. Hypobiosis (a state of dormancy in the host with the capability of reactivation and establishing intestinal infection over long periods) among helminths is accentuated in the presence of a low CD4 count. This makes HIV-positive patients often have a higher load of helminths. The study sought to determine the pattern, prevalence, and specie specific prevalence of intestinal helminthiasis in children living with HIV and HIV seronegative controls. Material and Methods: This was a comparative cross-sectional study, conducted amongst 256 sero-positive children, and 268 matched controls recruited into the study between October and December 2022. Subjects were excluded if they had been given any antihelminth in the six weeks preceding enrollment. Data were collected using a structured interviewer-administered questionnaire. Fresh stool samples were analyzed using the Kato-Katz method. Results: The prevalence of intestinal helminthiasis in children living with HIV was 47.7% and 36.6% amongst the sero-negative control population (p = 0.7589). Among the subjects and controls, the highest prevalence was seen in the 5-9 year age group, while those over 15 years had the lowest prevalence. These differences in the prevalence of helminths infection amongst the various age groups were significant in the subjects only and not in the controls. Of all the STHI, Hookworm infection constituted the majority 52.5%.  Multiple STHI were seen in 20.7% of subjects living with HIV, while 9.3% were seen in the control. The difference is statistically significant (p = .00003). Conclusion: Soil-transmitted helminthic infection is more prevalent in children living with HIV than in apparently healthy children. Regular deworming should be considered in the care of children living with HIV.