Opportunistic Parasitic Infections among HIV-Positive Patients in South-West Nigeria

Opportunistic parasitic infections (OPIs) constitute a major factor leading to morbidity among people living with HIV (PLHIV), especially in the economically disadvantaged areas. This study investigated the prevalence, distribution, diagnostic awareness, and treatment practices of OPIs among HIV-positive adults attending antiretroviral therapy (ART) clinics in three tertiary hospitals across South-West Nigeria. A cross-sectional design was used to collect socio-demographic data, clinical history, diagnostic awareness, and treatment preferences through structured questionnaires. Stool and blood samples were analysed for intestinal and blood-borne parasitic infections using standard microscopy techniques. Sixty four (38.3%) out of the 167 adult HIV-positive participants recruited for the study tested positive for at least one opportunistic parasitic infection. Intestinal parasites accounted for 15.6% of cases, blood-borne parasites for 12.6%, while 10.2% had co-infections. Entamoeba histolytica (8.4%) and Giardia lamblia (4.8%) were the most prevalent intestinal parasites, whereas Plasmodium falciparum (12.6%) was the only blood-borne parasite. Below half (41.3%) of respondents had previously participated in parasitic infections sreening, majority (90.4%) of participants showed willingness to adopt improved diagnostic techniques. Conventional therapy was the preferred treatment approach, but 26.3% reported combined use of herbal and orthodox treatments. While infection burden appeared higher among female urban residents, no statistically significant (p > 0.05) association was between socio-demographic characteristics and infection status. The findings highlight a persistently high burden of OPIs among PLHIV in South-West Nigeria and underscore the need to integrate routine parasitic screening and more sensitive diagnostic techniques into HIV care to improve patient outcomes.