Prevalence of Microsporidia in HIV-infected Patientsin Iran: A Meta-Analysis and Systematic Review

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.

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.

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.

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.