{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:32:39Z","timestamp":1790645559084,"version":"4.1.0"},"reference-count":70,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ESTHER Alliance for Global Health Partnerships"},{"name":"German Federal Ministry of Education and Research","award":["01KA1102"],"award-info":[{"award-number":["01KA1102"]}]},{"name":"German Ministry of Defense","award":["36K2-S-45 1922"],"award-info":[{"award-number":["36K2-S-45 1922"]}]},{"name":"Heinz Ansmann Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Objectives: This observational and cross-sectional study investigated differential associations between entero-invasive and non-entero-invasive enteric pathogens and HIV infection, considering socioeconomic, clinical and immunological aspects. In a Ghanaian population with a high prevalence of enteric pathogens, stool samples from people living with HIV (PLWH) were screened for Salmonella spp., Shigella spp.\/EIEC (enteroinvasive Escherichia coli), and Campylobacter jejuni as entero-invasive bacteria, for enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), and enteroaggregative E. coli (EAEC) as non-entero-invasive bacteria. Arcobacter butzleri, with uncertain enteropathogenicity, was also included. Methods: Stool samples from PLWH (with and without antiretroviral therapy) and HIV-negative controls were analyzed by real-time PCR for the presence and quantity of the selected enteropathogens. Results were correlated with socioeconomic, clinical, and immunological parameters. Results: The presence of Shigella spp. \/EIEC in stool was both qualitatively and quantitatively associated with reduced CD4+ T lymphocyte counts and was qualitatively associated with clinically apparent diarrhea. EAEC showed a weak positive association with HIV infection, supported by a negative correlation between EAEC DNA quantity and CD4+ T lymphocyte counts. EPEC colonization was associated with HIV negativity, higher CD4+ T lymphocyte counts, and lower socioeconomic status. Abundance of Salmonella enterica was associated with clinically apparent diarrhea. Conclusions: This explorative, hypothesis-forming study suggests species- or pathovar-specific associations between enteric bacterial pathogens and HIV-related immunosuppression. Observed relationships with clinically apparent diarrhea largely align with findings from sub-Saharan African children, except for a more pronounced association between diarrhea and Salmonella in this cohort.<\/jats:p>","DOI":"10.3390\/medsci13040316","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T09:37:48Z","timestamp":1765532268000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of Entero-Invasive and Non-Entero-Invasive Diarrheagenic Bacteria Among HIV-Positive and HIV-Negative Adults in Ghana"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8967-9528","authenticated-orcid":false,"given":"Hagen","family":"Frickmann","sequence":"first","affiliation":[{"name":"Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 22049 Hamburg, Germany"},{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred Stephen","family":"Sarfo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana"},{"name":"Department of Internal Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4075-5972","authenticated-orcid":false,"given":"Betty Roberta","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana"},{"name":"Department of Internal Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Dompreh","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadrack Osei","family":"Asibey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3599-9136","authenticated-orcid":false,"given":"Richard","family":"Boateng","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1604-8386","authenticated-orcid":false,"given":"Veronica","family":"Di Cristanziano","sequence":"additional","affiliation":[{"name":"Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-9341","authenticated-orcid":false,"given":"Tafese Beyene","family":"Tufa","sequence":"additional","affiliation":[{"name":"Asella Referral and Teaching Hospital, College of Health Sciences, Arsi University, Asella P.O. Box 04, Ethiopia"},{"name":"Hirsch Institute of Tropical Medicine (HITM), Heinrich Heine University, Asella P.O. Box 04, Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital and Medical Faculty of the Heinrich Heine University, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Loderst\u00e4dt","sequence":"additional","affiliation":[{"name":"Institute of Infection Control and Infectious Diseases, University Medical Center G\u00f6ttingen, 37075 G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Binder","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Transfusion Medicine Department, IMD Laboratory Greifswald, 17493 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-013X","authenticated-orcid":false,"given":"Andreas Erich","family":"Zautner","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine and Microbiology & Vaccination Center, Klinikum W\u00fcrzburg Mitte, Campus Juliusspital, 97070 W\u00fcrzburg, Germany"},{"name":"Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6288-8821","authenticated-orcid":false,"given":"Tom","family":"Luedde","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital and Medical Faculty of the Heinrich Heine University, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-4492","authenticated-orcid":false,"given":"Torsten","family":"Feldt","sequence":"additional","affiliation":[{"name":"Hirsch Institute of Tropical Medicine (HITM), Heinrich Heine University, Asella P.O. Box 04, Ethiopia"},{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital and Medical Faculty of the Heinrich Heine University, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1002-0326","authenticated-orcid":false,"given":"Kirsten Alexandra","family":"Eberhardt","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital and Medical Faculty of the Heinrich Heine University, 40225 D\u00fcsseldorf, Germany"},{"name":"Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, 20359 Hamburg, Germany"},{"name":"I. Department of Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/j.1440-1746.1994.tb01729.x","article-title":"AIDS and the gut","volume":"9","author":"Chui","year":"1994","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_2","first-page":"247923","article-title":"Human immunodeficiency virus-associated gastrointestinal disease: Common endoscopic biopsy diagnoses","volume":"2011","author":"Bhaijee","year":"2011","journal-title":"Patholog. Res. 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