The clinical spectrum of hepatic cystic echinococcosis in a population with high human immunodeficiency virus prevalence: a retrospective cohort study in South Africa
- 1Surgical Gastroenterology Unit, Department of Surgery, University of Cape Town Health Sciences Faculty and Groote Schuur Hospital, Cape Town, South Africa
- 2Department of General Surgery, Section of Abdominal Transplant Surgery, Washington University St Louis, St. Louis, MO, USA
- 3Bioinformatics Unit, International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town, South Africa
Abstract
Objectives: Human immunodeficiency virus (HIV) may impair immune responses to parasitic diseases such as cystic echinococcosis (CE), potentially affecting its clinical presentation and diagnosis.
Methods: We compared the demographics, clinical features, and laboratory findings in patients with hepatic CE (HCE) with and without HIV infection at a tertiary facility in South Africa from 2011 to 2023.
Results: Among 91 patients, 48 (52.7%) had HIV infection and 67 (73.6%) were female, with a median age of 33 years. Abdominal pain was the most common symptom in both groups (∼79%). Abdominal tenderness and palpable mass were the most frequent signs. Jaundice was less common in patients with HIV than those without HIV (P = 0.019) as were bilirubin levels (P = 0.039) and white cell counts (P = 0.038). CE serology was negative in 25.0% of patients with HIV compared with 9.3% without HIV (P = 0.053). Most patients with HIV (88.1%) were receiving antiretroviral therapy and 45.8% had advanced HIV disease. HIV and CE were diagnosed simultaneously in 29.6%.
Conclusion: HIV prevalence among patients with HCE was approximately four times the national prevalence (12.7%), suggesting an association between HIV and CE. The higher rate of seronegativity in patients living with HIV may have implications for CE diagnosis in high–HIV prevalence settings.
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BibTeX
@article{couzensbohlin2026clinical,
title = {{The clinical spectrum of hepatic cystic echinococcosis in a population with high human immunodeficiency virus prevalence: a retrospective cohort study in South Africa}},
author = {Kate Couzens-Bohlin and Urda Kotze and Jeandre Malherbe and Jessica Lindemann and Jake Krige and Christo Kloppers and Marc Bernon and Galya Chinnery and Stefano Cacciatore and Eduard Jonas},
journal = {IJID regions},
year = {2026},
month = sep,
doi = {10.1016/j.ijregi.2026.101022},
url = {https://europepmc.org/article/PMC/PMC13725469},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The clinical spectrum of hepatic cystic echinococcosis in a population with high human immunodeficiency virus prevalence: a retrospective cohort study in South Africa
AU - Kate Couzens-Bohlin
AU - Urda Kotze
AU - Jeandre Malherbe
AU - Jessica Lindemann
AU - Jake Krige
AU - Christo Kloppers
AU - Marc Bernon
AU - Galya Chinnery
AU - Stefano Cacciatore
AU - Eduard Jonas
PY - 2026
DA - 2026/09/23
JO - IJID regions
DO - 10.1016/j.ijregi.2026.101022
UR - https://europepmc.org/article/PMC/PMC13725469
AB - Objectives: Human immunodeficiency virus (HIV) may impair immune responses to parasitic diseases such as cystic echinococcosis (CE), potentially affecting its clinical presentation and diagnosis. Methods: We compared the demographics, clinical features, and laboratory findings in patients with hepatic CE (HCE) with and without HIV infection at a tertiary facility in South Africa from 2011 to 2023. Results: Among 91 patients, 48 (52.7%) had HIV infection and 67 (73.6%) were female, with a median age of 33 years. Abdominal pain was the most common symptom in both groups (∼79%). Abdominal tenderness and palpable mass were the most frequent signs. Jaundice was less common in patients with HIV than those without HIV (P = 0.019) as were bilirubin levels (P = 0.039) and white cell counts (P = 0.038). CE serology was negative in 25.0% of patients with HIV compared with 9.3% without HIV (P = 0.053). Most patients with HIV (88.1%) were receiving antiretroviral therapy and 45.8% had advanced HIV disease. HIV and CE were diagnosed simultaneously in 29.6%. Conclusion: HIV prevalence among patients with HCE was approximately four times the national prevalence (12.7%), suggesting an association between HIV and CE. The higher rate of seronegativity in patients living with HIV may have implications for CE diagnosis in high–HIV prevalence settings.
SN - 2772-7076
ER -