机会性肠道原虫引起的腹泻是HIV感染的常见问题。我们的目的是确定隐孢子虫的患病率,misrosporaria,使用系统评价和荟萃分析,这是发展公共政策和临床服务的核心。
我们搜索了PubMed,ScienceDirect,谷歌学者,Embase,中文知识网,万方,和重庆VIP数据库报告隐孢子虫的研究,微孢子虫,或者HIV感染者的Isospora感染。我们提取了感染艾滋病毒和原生动物的人数,并通过随机效应模型估计寄生虫感染的合并患病率。
我们的研究确定了131项报告隐孢子虫的研究,微孢子虫,以及HIV感染者的Isospora感染。我们估计隐孢子虫的合并患病率为14.0%(3283/43,218;95%CI:13.0-15.0%),微孢子虫11.8%(1090/18,006;95%CI:10.1-13.4%),Isospora为2.5%(788/105,922;95%CI:2.1-2.9%)。在高收入国家发现微孢子虫和异孢子虫感染的患病率较低,并且在撒哈拉以南非洲发现了高流行的隐孢子虫和异孢子虫感染。我们还检测到隐孢子虫的患病率很高,微孢子虫,腹泻患者的异孢菌感染。敏感性分析显示,三项研究显著影响Isospora的患病率,通过排除这些研究,将其调整为5.0%(469/8570;95%CI:4.1-5.9%)。
我们的研究结果表明,HIV感染者的隐孢子虫流行率很高,微孢子虫,低收入国家和腹泻患者的Isospora感染,尤其是在撒哈拉以南非洲,加强对HIV感染者中机会性肠道原生动物常规监测的重要性。
Diarrhea caused by opportunistic intestinal protozoa is a common problem in HIV infection. We aimed to establish the prevalence of Cryptosporidium, misrosporidia, and Isospora in HIV-infected people using a systematic review and meta-analysis, which is central to developing public policy and clinical services.
We searched PubMed, ScienceDirect, Google Scholar, Embase, Chinese Web of Knowledge, Wanfang, and Chongqing VIP databases for studies reporting Cryptosporidium, microsporidia, or Isospora infection in HIV-infected people. We extracted the numbers of people with HIV and protozoa infection, and estimated the pooled prevalence of parasite infection by a random effects model.
Our research identified 131 studies that reported Cryptosporidium, microsporidia, and Isospora infection in HIV-infected people. We estimated the pooled prevalence to be 14.0% (3283/43,218; 95% CI: 13.0-15.0%) for Cryptosporidium, 11.8% (1090/18,006; 95% CI: 10.1-13.4%) for microsporidia, and 2.5% (788/105,922; 95% CI: 2.1-2.9%) for Isospora. A low prevalence of microsporidia and Isospora infection was found in high-income countries, and a high prevalence of Cryptosporidium and Isospora infection was found in sub-Saharan Africa. We also detected a high prevalence of Cryptosporidium, microsporidia, and Isospora infection in patients with diarrhea. Sensitivity analysis showed that three studies significantly affect the prevalence of Isospora, which was adjusted to 5.0% (469/8570; 95% CI: 4.1-5.9%) by excluding these studies.
Our findings suggest that HIV-infected people have a high prevalence of Cryptosporidium, microsporidia, and Isospora infection in low-income countries and patients with diarrhea, especially in sub-Saharan Africa, reinforcing the importance of routine surveillance for opportunistic intestinal protozoa in HIV-infected people.