HUMAN CRYPTOSPORIDIOSIS

Cryptosporidium parvum is a protozoan which can cause severe debilitat ing disease in immunocompromised individuals. Animal models have shown that cellular immunity is the most important factor against the devel opment of the disease. Individuals with a humoral immune deficiency ar e also at risk. Ln HN-infected patients there is a clear relationship between disease severity and CD4 cell counts. Insight into the pathoge nesis and development of new agents is hampered by the lack of an in v itro culture system. Prevention is of the utmost importance due to the difficulties of therapy and the severity of the clinical disease whic h can develop. Oocysts are highly resistant to commonly used disinfect ants. In HIV-infected patients with cryptosporidiosis, antiretroviral therapy should be instituted or modified. Moreover, non-specific thera py with antidiarrhoeal agents should also be instituted. if no effect is seen, therapy with paromomycin 500 mg 4 times daily for 2-3 weeks s hould be initiated, followed by maintenance therapy with 500 mg twice daily to prevent relapse.