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Di Cristanziano V, Weimer K, Böttcher S, Sarfo FS, Dompreh A, Cesar LG, Knops E, Heger E, Wirtz M, Kaiser R, Norman B, Phillips RO, Feldt T, Eberhardt KA. Molecular Characterization and Clinical Description of Non-Polio Enteroviruses Detected in Stool Samples from HIV-Positive and HIV-Negative Adults in Ghana. Viruses 2020; 12:v12020221. [PMID: 32079128 PMCID: PMC7077198 DOI: 10.3390/v12020221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/31/2020] [Accepted: 02/12/2020] [Indexed: 02/07/2023] Open
Abstract
In the post-polio eradication era, increasing attention is given to non-polio enteroviruses. Most of the data about enteroviruses in sub-Saharan Africa are related to acute flaccid paralysis surveillance and target the pediatric population. This study aimed to investigate the presence of enterovirus in PLHIV (people living with HIV) and HIV-negative individuals in Ghana. Stool samples from HIV-positive individuals (n = 250) and healthy blood donors (n = 102) attending the Komfo Anokye Teaching Hospital in Kumasi, Ghana, were screened by real-time PCR for enterovirus. Molecular typing of the VP1 region was performed. Enterovirus-positive samples were tested for norovirus, adenovirus, rotavirus, sapovirus, and cosaviruses. Twenty-six out of 250 HIV-positive subjects (10.4%) and 14 out of 102 HIV-negative individuals (13.7%) were detected enterovirus-positive, not showing a significant different infection rate between the two groups. HIV-negative individuals were infected with Enterovirus C strains only. HIV-positive participants were detected positive for species Enterovirus A, Enterovirus B, and Enterovirus C. Co-infections with other viral enteric pathogens were almost exclusively detected among HIV-positive participants. Overall, the present study provides the first data about enteroviruses within HIV-positive and HIV-negative adults living in Ghana.
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Affiliation(s)
- Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Kristina Weimer
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Sindy Böttcher
- National Reference Centre for Poliomyelitis and Enteroviruses, Robert Koch Institute, 13353 Berlin, Germany;
| | - Fred Stephen Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (F.S.S.); (B.N.); (R.O.P.)
- Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana;
| | | | | | - Elena Knops
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Eva Heger
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Maike Wirtz
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Rolf Kaiser
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, 50935 Cologne, Germany; (V.D.C.); (K.W.); (E.K.); (E.H.); (M.W.); (R.K.)
| | - Betty Norman
- Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (F.S.S.); (B.N.); (R.O.P.)
- Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana;
| | - Richard Odame Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (F.S.S.); (B.N.); (R.O.P.)
- Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana;
- Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi 00233, Ghana
| | - Torsten Feldt
- Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, 40225 Düsseldorf, Germany;
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20359 Hamburg, Germany
- Correspondence: ; Tel.: +49-40-428-180
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Di Cristanziano V, D´Alfonso R, Berrilli F, Sarfo FS, Santoro M, Fabeni L, Knops E, Heger E, Kaiser R, Dompreh A, Phillips RO, Norman B, Feldt T, Eberhardt KA. Lower prevalence of Blastocystis sp. infections in HIV positive compared to HIV negative adults in Ghana. PLoS One 2019; 14:e0221968. [PMID: 31479472 PMCID: PMC6719849 DOI: 10.1371/journal.pone.0221968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/18/2019] [Indexed: 12/20/2022] Open
Abstract
Background Sub-Saharan Africa is endemic for intestinal parasites and distinguished for the largest burden of HIV cases. Blastocystis sp. is one of the most common protists infecting humans but its role in human disease is still controversial. Aim of this study was to investigate the prevalence of Blastocystis sp. in HIV positive and negative adults in Ghana and its association with immune status and other risk factors. Methods 122 HIV positive outpatients and 70 HIV negative blood donors from the Komfo Anokye Teaching Hospital in Kumasi, Ghana, were included in the present study. Demographic, clinical and laboratory data were collected and HIV positive patients distinguished for CD4+ T cell count <200 cells/μl (n = 54) and >200 cells/μl (n = 68). A Blastocystis’s phylogenetic analysis was performed to determine sample subtype (ST). Results The prevalence of Blastocystis sp. in adult HIV positive individuals was lower than in HIV negative persons (6.6% vs. 20.0%, p = 0.008) and Blastocystis sp. ST1 was the most prevalent strain. Within HIV positive participants, the prevalence of Blastocystis sp. was lower in those individuals with CD4+ T cell count <200 cells/μl than in patients with higher CD4+ T cell count (1.9% vs. 10.3%, p = 0.076). Multiple regression analysis revealed that Blastocystis sp. was inversely associated with an obese Body Mass Index (BMI) in HIV negative persons (p = 0.040). Presence of Blastocystis sp. was correlated with higher CD4+ T cell count in HIV positive participants (p = 0.049). Conclusion It is largely reported that people living with HIV (PLHIV) in Africa are affected from parasite infections and that co-infections may adversely impact on their immune status, accelerating progress to AIDS and worsening gastrointestinal manifestations. Differently, in this study Blastocystis sp. was associated with a better immune status jointly with a healthy body weight while it seems to be reduced with the progression of HIV infection. This data agree with recent suggestions that Blastocystis sp. can represent a component of the healthy gut microbiota.
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Affiliation(s)
- Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Rossella D´Alfonso
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Federica Berrilli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fred Stephen Sarfo
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Maristella Santoro
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lavinia Fabeni
- National Institute for Infectious Diseases L. Spallanzani—IRCCS, Rome, Italy
| | - Elena Knops
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Eva Heger
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Rolf Kaiser
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | | | - Richard Odame Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Kumasi Center for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Betty Norman
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Torsten Feldt
- Clinic of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
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Hong H, Budhathoki C, Farley JE. Effectiveness of macronutrient supplementation on nutritional status and HIV/AIDS progression: A systematic review and meta-analysis. Clin Nutr ESPEN 2018; 27:66-74. [PMID: 30144895 PMCID: PMC6112859 DOI: 10.1016/j.clnesp.2018.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/21/2018] [Accepted: 06/22/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS Malnutrition is common in Sub-Saharan Africa, weakening the immune function of persons living with HIV infection (PLWH). Being malnourished at the initiation of antiretroviral therapy (ART) leads to higher risk of early mortality and reduced quality of life. Thus, introduction of protein-energy-fortified macronutrient supplements at ART initiation may improve HIV treatment outcomes. This review aimed to evaluate the effectiveness of macronutrient interventions. METHODS This systematic review and meta-analysis included 15 studies conducted from 2000 to 2015 among Sub-Saharan African adults. RESULTS Six randomized controlled trials and 4 retrospective cohort studies provided data eligible for a meta-analysis. Supplementation significantly increased the overall standardized mean difference (SMD) between baseline and follow-up data in weight (SMD = 0.382, p < .001), BMI (SMD = 0.799, p < .001); fat-free mass (SMD = 0.154, p = .009); and CD4 count (SMD = 0.428, p < .001). CONCLUSION Protein-energy-fortified macronutrient supplementation at ART initiation may positively influence nutritional status and immunologic response in PLWH in Sub-Saharan Africa.
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Affiliation(s)
- Hyejeong Hong
- Johns Hopkins University School of Nursing, Department of Community-Public Health, 525 North Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Nursing, The REACH Initiative, 1909 McElderry Street, SON House, Baltimore, MD, 21205, USA.
| | - Chakra Budhathoki
- Johns Hopkins University School of Nursing, Department of Acute and Chronic Care, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
| | - Jason E Farley
- Johns Hopkins University School of Nursing, Department of Community-Public Health, 525 North Wolfe Street, Baltimore, MD, 21205, USA; Johns Hopkins University School of Nursing, The REACH Initiative, 1909 McElderry Street, SON House, Baltimore, MD, 21205, USA.
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