Comparative epidemiology of Ghanaian individuals with molecular proof of Entamoeba histolytica with and without concomitant human immunodeficiency virus infection.

Introduction: Entamoeba histolytica is the causative agent of enteric amebiasis in human patients. Partly controversial hypotheses have been proposed regarding the potential impact of the immunological status of patients as well as HIV (human immunodeficiency virus) positivity on the prevalence and clinical course of amebiasis. Methods: To investigate a potential interplay between the epidemiology of E. histolytica and immunological markers of Ghanaian HIV patients, real-time PCR targeting E. histolytica DNA in stool samples was conducted on a cohort of 595 clinically and immunologically well-characterized adult Ghanaian HIV patients, along with 82 HIV negative control-individuals. Results: E. histolytica DNA was more prevalent in the HIV-negative control group (12.2%, n = 10/82) compared to the HIV-positive subpopulation (3.5%, n = 21/595, P = 0.001). Among HIV-positive individuals, the prevalence of E. histolytica DNA was 4.2% in subjects with CD4+ T cell counts above 200 cells/µL, 3.3% in case of 50 and 200 cells/µL, and 0% in case of less than 50 cells/µL. In the group of ART-exposed HIV-positive individuals, E. histolytica positivity was associated to lower CD4+/CD8+ cell ratios. Conclusions: The study suggested a negative association of E. histolytica DNA detections with HIV-positivity and with the degree of HIV infection-associated immunosuppression.