:: Volume 28, Issue 3 (7-2020) ::
Journal of Ilam University of Medical Sciences 2020, 28(3): 21-28 Back to browse issues page
Prevalence of Microsporidia in HIV-infected Patients in Iran: A Meta-Analysis and Systematic Review
Jahangir Abdi1 , Morteza Shams1 , Yousef Visani2 , Mohammad Karimiyan3 , Azra Kenarkoohi * 4
1- Zoonotic Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
2- Psychosocial Trauma Research Center, Ilam University of Medical Sciences, Ilam, Iran
3- Dept of General Surgery, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
4- Dept of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran , a_kenarkoohi@yahoo.com
Abstract:   (3376 Views)
Introduction: Microsporidiosis is an increasing opportunistic infection in patients with HIV/AIDS. There are five species of Microsporidia, including Enterocytozoon bieneusi, Encephalitozoon hellem, Encephalitozoon cuniculi, Septata intestinalis, and Pleistophora species that have been reported in HIV-infected individuals each causes a wide range of symptoms. This meta-analysis and systematic review aimed at determining the prevalence of Microsporidia in HIV-infected patients in Iran.
 
 Materials & Methods: Databases of Magiran, Scopus, Web of Sciences, Iran Medex, SID, Pubmed, Google scholar, and Irandoc were searched to investigate the studies on "Prevalence of Microsporidia in patients with HIV/AIDS in Iran". Moreover, the meta-analysis was performed using a random-effect model, and the heterogeneity among the studies was determined using the I2 test.
 
Findings: Based on the data obtained from the studies, out of 8 studies, 1794 patients with HIV/AIDS were investigated in Iran between 2012 and 2016. According to the results, the prevalence of Microsporidia in patients with HIV/AIDS was evaluated using the PCR technique (0.8-0.18: %95 CI, 13%). The amount of heterogeneity among the studies (P<0.001) was obtained at I2=93.3. The most common Microsporidia were Enterocytozoon bieneusi, D, M, and WL-11 genotypes. However, Encephalitozoon intestinalis, Encephalitozoon cuniculi (genotypes 1 and 2), and Encephalitozoon hellem (genotype 1A) were also isolated.
 
Discussion & Conclusions: The present study showed that the mean prevalence of Microsporidia in patients with HIV/AIDS in Iran (13%) is close to its global mean (15%). The most common Microsporidia in HIV-infected patients is Enterocytozoon bieneusi (genotype D) which is a common genotype between humans and animals; therefore, the patients should avoid contact with animals.
 
Keywords: Immune deficiency, Microsporidiosis, Opportunistic infections
Full-Text [PDF 559 kb]   (1279 Downloads)    
Type of Study: Research | Subject: public health
Received: 2020/01/19 | Accepted: 2020/04/11 | Published: 2020/08/31
References
1. Gharibi Z, Daadras F, Maghsood M, Fallah, M, Saeedijam M. Identification of intestinal microsporidia by trichrome staining and calcofluor white methods among kidney transplanted patients in Hamadan. Med Lab J 2014;7:47-52.
2. Ghorbanzadeh B, Sadraie J, Emadikuchak H. [Diagnosis of Cryptosporidium and intestinal Microsporidia in HIV/AIDS patients with staining and PCR methods on 16srRNA gen]. J Arak Uni Med Sci 2012;15:37-47.(Persian)
3. Asghari A, Ebrahimzadehparikhani H, Zare M. [A general overview of the history and characteristics of Microsporidia and investigation of the prevalence, diagnostic methods and treatment of Microsporidiosis in HIV+ patients]. Lab Diag 2019;10:67-75. (Persian)
4. Pirestani M, Sadraei J, Forouzandehmoghadam M. [Detection and genotyping of human associated microsporidia in pigeon Columba livia of Tehran in 2010]. Pathobiol Res 2011;14:15-24.(Persian)
5. Franzen C, Muller A. Molecular techniques for detection species differentiation and phylogenetic analysis of microsporidia. Clin Microbiol Rev1999;12:243-85.
6. Weber R, Bryan RT, Schwartz DA, Owen RL. Human microsporidial infections. Clin Microbiol Rev 1994;7:426-61.
7. Garcia LS. Laboratory identification of the microsporidia. J Clin Microbiol 2002;40:1892-901. doi. 10.1128/JCM.40.6.1892–1901.2002.
8. Mirjalali H, Mohebali M, Mirhendi H, Gholami R, Keshavarz H, Meamar AR, et al. Emerging intestinal microsporidia infection in AIDS patients in Iran microscopic and molecular detection. Iran J Parasitol2014;9:149-54.
9. Masoumiasl H, Khanaliha K, Bokharaeisalim F, Esteghamati A, Kalantari S, Hosseinyrad M. Enteric opportunistic infection and the impact of antiretroviral therapy among HIV patients from Tehran Iran. Iran J Publ Health2019;48:730-9.
10. Agholi M, Hatam GR, Motazedian MH. HIV/AIDS associated opportunistic protozoal diarrhea. Aids Res Hum Ret 2013;29:35-41. doi.10.1089/aid.2012.0119
11. Zhang W, Ren G, Zhao W, Yang Z, Shen Y, Sun Y, et al. Genotyping of Enterocytozoon bieneusi and subtyping of Blastocystis in cancer patients relationship to diarrhea and assessment of zoonotic transmission. Front Microbiolo 2017;8:1835-9. doi.10.3389/ fmicb.2017. 01835.
12. Nissapatorn V, Sawangjaroen N. Parasitic infections in HIV infected individuals diagnostic therapeutic challenges. Indian J Med Res 2011;134:878-97. doi.10.4103/0971-5916.92633 13. Chawla R, Ichhpujani RL. Enteric spore forming opportunistic parasites in HIV. Trop Parasitol 2011;1:15-9. doi.10.4103/2229-5070.72112.
13. Maartens G. Opportunistic infections associated with HIV infection in Africa. Oral Dis 2002;8:76-9. doi.10.1034/j.1601-0825.2002.00016.x.
14. Didier ES, Orenstein JM, Aldras A, Bertucci D, Rogers LB, Janney FA. Comparison of three staining methods for detecting microsporidia in fluids. J Clin Microbiol 1995;33:3138-45.
15. Tavallaa M, Mardanikatekib M, Abdizadehd R, Nashibie R, Abdollah Rafiea, Khademvatan SH. Molecular identification of Enterocytozoon bieneusi and Encephalitozoon spp. in immunodeficient patients in Ahvaz Southwest of Iran. Acta tropica2017;172: 107-12. doi. 10.1016/j.actatropica. 2017.04.015.
16. Pang W, Shang P, Li Q, Xu J, Bi L, Zhong J, et al. Prevalence of opportunistic infections and causes of death among hospitalized HIV infected patients in Sichuan China. Tohoku J Exp Med2018;244:231-42.
17. Mirjalali H, Mirhendi H, Meamar AR, Mohebali M, Askari Z, Mirsamadi ES, et al. Genotyping and molecular analysis of Enterocytozoon bieneusi isolated from immunocompromised patients in Iran. Infect Genet Evol 2015;36:244-9. doi. 10.1016/j.meegid. 2015.09.022.
18. Nooshadokht M, Sharifi I, Mohammadi MA, Pirestani M, Afgar A, Mahootchi A, et al. Intestinal microsporidiosis in Iran: infection in immune compromised and immunocompetent patients. Curr Med Mycol 2017;3:30-6. doi.10.29252/ cmm.3.1.30.
19. Muller A, Bialek R, Kamper A, Fatkenheuer G, Salzberger B, Franzen C. Detection of microsporidia in travelers with diarrhea. J Clin Microbiol 2001;39:1630-2. doi. 10.1128/JCM.39.4.1630-1632.2001.
20. Agholi M, Shahabadi SN, Motazedian MH, Hatam GR. Prevalence of enteric protozoan oocysts with special reference to Sarcocystis cruzi among fecal samples of diarrheic immunodeficient patients in Iran. Korean J Parasitol 54: 339-44. doi.10.3347/kjp.2016.54.3.339.
21. Kazemi E, Tavalla M, Maraghi, Jafaryad, and Latifi M. Frequency of microsporidial infection in immunocompromised patients with staining and molecular methods based on internal transcribed spacer region gene in two cities of Southwest Iran during 2013-4. Asian J Pharmaceut Res Health Care 2017; 9: 7-16.



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