NITAZOXANIDE IN THE TREATMENT OF CRYPTOSPORIDIAL DIARRHEA AND OTHER INTESTINAL PARASITIC INFECTIONS ASSOCIATED WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME IN TROPICAL AFRICA

Eighteen patients hospitalized with intestinal parasitic infections as sociated with diarrhea and dehydration completed a study of nitazoxani de in the treatment of Cryptosporidium parvum and other intestinal par asitic infections. Seventeen of the 18 patients were positive for huma n immunodeficiency virus. Twelve patients were diagnosed with clinical Stage 4 acquired immunodeficiency syndrome (AIDS) according to the 19 90 World Health Oganization proposed clinical classification system an d cryptosporidiosis. Nitazoxanide (500 mg tablets) were administered o rally, one tablet twice a day for seven consecutive days. Cryptosporid ium parvum oocysts were eradicated or reduced by more than 95% in seve n of the 12 Stage 4 AIDS patients who completed the study based upon t wo post-treatment fecal examinations conducted on days 7 and 14 follow ing the initiation of treatment. The elimination or reduction of C. pa rvum oocysts was associated with a complete resolution of diarrhea in four of the seven patients. The test drug was also effective against c ases of Isospora belli. Entamoeba histolytica, Giardia lamblia, Ascari s lumbricoides, Enterobius vermicularis, Hymenolepis nana, and Dicroco elium dentriticum. Treatment with nitazoxanide was well tolerated by t he patients. There were no abnormalities in blood chemistry or hematol ogy data that were considered to be attributable to nitazoxanide thera py. Transient episodes of vomiting were observed in four patients, all with Stage 4 AIDS and cryptosporidiosis, which resolved spontaneously without discontinuation of treatment and were not considered to be re lated to administration of nitazoxanide.