Intestinal Colonization with -Clinical and Immunological Implications for HIV Positive Adults in Ghana.

Background: Recent studies demonstrated higher prevalence rates of () in HIV positive than in HIV negative subjects. However, associations with the immune status in HIV positive participants were conflicting.

Methods: For this cross-sectional study, stool samples of 906 HIV positive and 98 HIV negative individuals in Ghana were tested for . Additionally, sociodemographic parameters, clinical symptoms, medical drug intake, and laboratory parameters were assessed.

Results: The prevalence of was 5.85% in HIV positive and 2.04% in HIV negative participants. Within the group of HIV positive participants, the prevalence reached 7.18% in patients without co-trimoxazole prophylaxis, 10.26% in subjects with ART intake, and 12.31% in obese participants. Frequencies of clinical symptoms were not found to be higher in HIV positive carriers compared to negative participants. Markers of immune activation were lower in patients colonized with . Multivariate regression models demonstrated an independent relationship of a high CD4+ T cell count, a low HIV-1 viral load, and an obese body weight with the presence of .

Conclusions: Among HIV positive individuals, colonization was associated with a better immune status but not with clinical consequences. Our data suggest that the withdrawal of co-trimoxazole chemoprophylaxis among people living with HIV on stable cART regimen may inadvertently increase the propensity towards colonization with .