First time genotyping of Cryptosporidium spp. isolates from diarrheic stools of Algerian HIV-Infected subjects supports predominant zoonotic transmission routes

BackgroundCryptosporidium is a significant cause of chronic diarrhoea and death in HIV-infected patients. Although HIV-infected patients under HAART have currently reduced risk of suffering from opportunistic infections, opportunistic gastrointestinal infections such as cryptosporidiosis still occur. Currently, there are no data on genetic characteristics of Cryptosporidium isolates from cryptosporidiosis patients in Algeria. This study was aimed at identifying Cryptosporidium species and subtype families prevalent in Algerian HIV-infected patients and contributing to the molecular epidemiology mapping of Cryptosporidium in the MENA region. MethodsFrom 2016 to 2018, 350 faecal specimens were obtained from patients with an HIV/AIDS positive status associated with diarrhoea attending inpatient (hospitalisation) and outpatient care units of El Hadi Flici (ex El- Kettar) hospital, Alger city, Algeria, and screened for the presence of Cryptosporidium using microscopy. Positive samples were submitted to the "Centre National de Reference-Laboratoire Expert-Cryptosporidioses", Rouen University Hospital, France, for molecular analysis (species, genotype) by DNA sequencing of the SSU18S rRNA and Gp60 genes, respectively. ResultsOut of 350 samples, 33 (9.4%) were microscopically positive for Cryptosporidium spp. of which 22 isolates were successfully amplified at the 18S rRNA and gp60 loci. Based on sequence analysis: 15 isolates were identified as C. parvum with family subtypes IIa-7, and IId-8, while 5 were identified as C. hominis (family subtypes Ia-2 and Ib-3) and 2 as C. felis. ConclusionThe predominance of C. parvum subtype families IIa and IId in this study highlights the potential importance of zoonotic cryptosporidiosis transmission to Algerian HIV-positive subjects. More extensive sampling of both humans and farm animals, especially sheep, goats and calves, and collection of epidemiological data are needed for better understanding of the sources of human C. parvum infections in Algeria. Author summaryCryptosporidiosis, an opportunistic infection, still represents a severe threat for HIV-infected individuals. Cryptosporidium parvum and Cryptosporidium hominis are the leading cause of human cryptosporidiosis. Besides, other species and genotypes of Cryptosporidium might infect both immunocompetent and immunocompromised subjects. In Algeria, no study has been conducted until now on the prevalence and molecular characteristics of Cryptosporidium-infection among HIV-infected individuals. Thus, this study aimed to examine the distribution and molecular characteristics of Cryptosporidium spp--isolates to provide clues to the understanding of transmission dynamics of species and genotypes to Algerian HIV-infected patients. Of 350 faeces samples, 33 were microscopy-positive for Cryptosporidium and molecular characterisation obtained for 22 isolates resulted in the identification of C. hominis, C. parvum, and C. felis. The frequent occurrence of the zoonotic IIa and IId subtype families of C. parvum was suggestive of widespread zoonotic transmission of cryptosporidiosis in Algeria, and warrants further extensive molecular epidemiological studies in both human and animal populations.