Detection and genetic characterization of the GP60 Gene of Cryptosporidium parvum isolated from HIV+/AIDS patients - Kurdistan Province, Northwest Iran: predominance of subtype IId

Abstract Background Cryptosporidium spp. is an important intestinal protozoan parasite causing morbidity and mortality in immunocompromised patients, particularly those with HIV+/AIDS. A cross-sectional study was conducted on 161 HIV+/AIDS patients in Kurdistan Province, Iran, aiming to assess prevalence and genetic diversity of Cryptosporidium spp. among HIV+/AIDS patients. Methods Stool samples were examined microscopically and by nested PCR targeting the GP60 gene. PCR-positive samples were sequenced, and phylogenetic analyses were conducted using MEGA12 software. Results Of 161 faecal samples from HIV+/AIDS patients, seven (4.34%) and four (2.48%) positive samples were detected by PCR and microscopy, respectively (OR = 1.94, P = 0.536). Two factors showed a statistically significant association with a higher risk of Cryptosporidium infection, including using untreated drinking water and contact with animals. Patients using untreated water had a 30% infection rate, compared to 2.6% for those using purified water (OR = 15.19, P = 0.011). Patients with animal contact had a 33.3% infection rate, compared to 3.2% for those without animal contact (OR = 14.73, P = 0.047). No significant association was found with the patient’s sex or urban/rural location. All isolates belonged to the C. parvum IId subtype. Phylogenetic analyses clustered all isolates within the IId clade, which are closely related to animal-derived subtypes. Conclusion The genetic similarity with previously reported animal isolates raises the possibility of zoonotic transmission; however, in the absence of animal or environmental sampling, this hypothesis remains speculative and should be interpreted with caution. These findings highlight the need for screening of Cryptosporidium among vulnerable populations, especially HIV+/AIDS patients.