Work

The clinical spectrum of hepatic cystic echinococcosis in a population with high human immunodeficiency virus prevalence: a retrospective cohort study in South Africa

Year: 2026

Type: article

Abstract: Background 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 demographics, clinical features and laboratory findings in patients with hepatic cystic echinococcosis (HCE), with and without HIV infection, at a tertiary facility in South Africa from 2011 to 2023. Findings 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%. Interpretation 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 HIV patients may have implications for CE diagnosis in high HIV-prevalence settings.

Source: IJID Regions

DOI: 10.1016/j.ijregi.2026.101022