{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:17:30Z","timestamp":1787584650817,"version":"build-2736575974"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772190"],"award-info":[{"award-number":["81772190"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81672003"],"award-info":[{"award-number":["81672003"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81871654"],"award-info":[{"award-number":["81871654"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005046","name":"Natural Science Foundation of Heilongjiang Province of China","doi-asserted-by":"crossref","award":["(LH2021H007)"],"award-info":[{"award-number":["(LH2021H007)"]}],"id":[{"id":"10.13039\/501100005046","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Harbin Medical University Scientific Research Innovation Fund","award":["(2016JCZX42)"],"award-info":[{"award-number":["(2016JCZX42)"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Human immunodeficiency virus (HIV) and enteric parasite co-infection not only aggravates the clinical symptoms of parasites but also accelerates acquired immunodeficiency syndrome (AIDS) progression. However, co-infection research on men who have sex with men (MSM), the predominant high-risk population of HIV\/AIDS in China, is still limited. In this study, we investigated the epidemiology of enteric parasites, risk factors, and associations with clinical significance in an MSM HIV\/AIDS population in Heilongjiang Province, northeast China.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We recruited 308 MSMs HIV\/AIDS patients and 199 HIV-negative individuals in two designated AIDS hospitals in Heilongjiang between April 2016 and July 2017. Fresh stool samples were collected. DNA extraction, molecular identification, and genotyping of <jats:italic>Cryptosporidium<\/jats:italic> species, <jats:italic>Entamoeba histolytica<\/jats:italic>, <jats:italic>Cyclospora cayetanensis<\/jats:italic>, <jats:italic>Enterocytozoon bieneusi<\/jats:italic>, and <jats:italic>Blastocystis hominis<\/jats:italic> were performed. Fourteen diarrhea-related pathogens were examined to exclude the influence of other bacterial pathogens on diarrhea incidence.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>31.5% of MSM HIV\/AIDS participants were infected with at least one parasite species, a significantly higher proportion than that found in the HIV-negative individuals (2.5%). <jats:italic>E<\/jats:italic>. <jats:italic>bieneusi<\/jats:italic> presented the highest prevalence, followed by <jats:italic>B<\/jats:italic>. <jats:italic>hominis<\/jats:italic>, <jats:italic>E<\/jats:italic>. <jats:italic>histolytica<\/jats:italic>, <jats:italic>Cryptosporidium<\/jats:italic> spp., and <jats:italic>C<\/jats:italic>. <jats:italic>cayetanensis<\/jats:italic>. Warm seasons were the risk factor for parasitic infections in this population [odds ratio (OR) = 2.6, 95% CI: 1.47\u20134.57]. In addition, these individuals showed a higher proportion (35.8%) of present diarrhea (PD) compared with men who have sex with women (MSW) with HIV\/AIDS (16.7%). The infection proportions of both <jats:italic>Cryptosporidium<\/jats:italic> spp. and <jats:italic>E<\/jats:italic>. <jats:italic>histolytica<\/jats:italic> were significantly higher in the PD. <jats:italic>E<\/jats:italic>. <jats:italic>bieneusi<\/jats:italic> infection was more prevalent in the historic diarrhea (HD) group. CD4<jats:sup>+<\/jats:sup> T cell counts in the MSM patients with the above three parasites were significantly lower. New species and genotypes were found, and MSM patients had a wider range of species or genotypes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Enteric parasitic infection was prevalent in the MSM HIV\/AIDS population, especially in patients with present diarrhea during warm seasons. <jats:italic>E<\/jats:italic>. <jats:italic>histolytica<\/jats:italic> and <jats:italic>B<\/jats:italic>. <jats:italic>hominis<\/jats:italic> should also be considered high-risk parasites for opportunistic infections in AIDS patients in addition to <jats:italic>Cryptosporidium<\/jats:italic> spp.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010712","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T17:26:45Z","timestamp":1662485205000},"page":"e0010712","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["A baseline 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