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Ramezanzadeh S, Beloukas A, Pagheh AS, Rahimi MT, Hosseini SA, Oliveira SMR, de Lourdes Pereira M, Ahmadpour E. Global Burden of Cyclospora cayetanensis Infection and Associated Risk Factors in People Living with HIV and/or AIDS. Viruses 2022; 14:v14061279. [PMID: 35746750 PMCID: PMC9228463 DOI: 10.3390/v14061279] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022] Open
Abstract
Cyclospora cayetanensis infections remain one of the most common protozoan opportunistic causes of gastrointestinal diseases and diarrhea among people living with HIV and/or AIDS (PLWHA). This study was conducted to provide a summary of the evidence on the global burden of C. cayetanensis infection and associated risk factors among PLWHA. Scopus, PubMed, Science Direct, and EMBASE were searched up to February 2022. All original peer-reviewed original research articles were considered, including descriptive and cross-sectional studies describing C. cayetanensis in PLWHA. Incoherence and heterogeneity between studies were quantified by I index and Cochran’s Q test. Publication and population bias were assessed with funnel plots and Egger’s asymmetry regression test. All statistical analyses were performed using StatsDirect. The pooled prevalence of C. cayetanensis infection among PLWHA was 3.89% (95% CI, 2.62–5.40). The highest prevalence found in South America was 7.87% and the lowest in Asia 2.77%. In addition, the prevalence of C. cayetanensis was higher in PLWHA compared to healthy individuals. There was a relationship between a higher C. cayetanensis prevalence in PLWHA with a CD4 cell count below 200 cells/mL and people with diarrhea. The results show that PLWHA are more vulnerable to C. cayetanensis infection and emphasizes the need to implement the screening and prophylaxis tailored to the local context. Owing to the serious and significant clinical manifestations of the parasite, an early identification of seropositivity is recommended to initiate prophylaxis between PLWHA with a CD4 count ≤200 cells/mL and PLWHA who do not receive antiviral therapy.
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Affiliation(s)
- Saba Ramezanzadeh
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran;
- Department of Parasitology and Mycology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran
| | - Apostolos Beloukas
- National AIDS Reference Center of Southern Greece, Department of Public Health Policy, University of West Attica, 11521 Athens, Greece;
- Molecular Microbiology & Immunology Lab, Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand 97178-53577, Iran;
| | - Mohammad Taghi Rahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud 36147-73955, Iran;
| | - Seyed Abdollah Hosseini
- Department of Parasitology and Mycology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 33971-48157, Iran;
| | - Sonia M. Rodrigues Oliveira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Maria de Lourdes Pereira
- CICECO-Aveiro Institute of Materials, University of Aveiro, 3810-193 Aveiro, Portugal;
- Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (M.d.L.P.); or (E.A.); Tel.: +351-234-378141 (M.d.L.P.); +98-413-5428595 (E.A.); Fax: +98-413-3373745 (E.A.)
| | - Ehsan Ahmadpour
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran;
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 51666-14766, Iran
- Correspondence: (M.d.L.P.); or (E.A.); Tel.: +351-234-378141 (M.d.L.P.); +98-413-5428595 (E.A.); Fax: +98-413-3373745 (E.A.)
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