O. Matos et al., PREVALENCE OF CRYPTOSPORIDIOSIS IN AIDS PATIENTS WITH DIARRHEA IN SANTA-MARIA-HOSPITAL, LISBON, Folia parasitologica, 45(2), 1998, pp. 163-166
We report the findings of a longitudinal observational study on HIV-in
fected patients grouped by presumed transmission group, who had diarrh
oea. The purpose of this study was to assess the prevalence of and fac
tors associated with Cryptosporidium infection on these patients. Modi
fied formol-ether concentration followed by modified Ziehl-Neelsen and
phenol-auramine/carbol-fuchsin staining techniques were used to ident
ify, Cryptosporidium from 465 patients. Cryptosporidiosis was reported
in 36/465 (8% and 95% confidence interval 6, 10) patients. Of the pos
itive patients 30 (83%) were men and 6 (17%) women. Prevalence of infe
ction was higher among HIV-seropositive patients whose exposure catego
ry was through sexual contact (69%) than among patients in other HIV e
xposure categories (9%, Standard Z test, P < 0.001). Median CD4+ cell
count/mm(3) was 120 (range 3-600). Besides diarrhoea, the main clinica
l manifestations were fever and weight loss in 14 (39%) and 26 (72%) p
atients, respectively. Cryptosporidium infection was considered to be
the first AIDS defining disease in 31% of the patients followed by tub
erculosis in 19%, Pneumocystis carinii pneumonia in 14%, Salmonella se
psis in 6%, isosporiasis in 3%, toxoplasmic encephalitis in 3%, leishm
aniasis in 3% and Kaposi's sarcoma in 3% of the patients. There was no
significant difference (P = 0.82) in survival times for those given f
olate antagonists to treat other opportunistic infections. The decreas
e in prevalence of cryptosporidiosis observed from 1994 until May 1997
is not statistically significant (P = 0.11). Most cases of cryptospor
idial infection in AIDS patients in Lisbon occurred in those whose HIV
infection was assumed to have been acquired by the sexual route (hete
ro-, homo- and bisexual), with few cases occurring in drug-abusers.