ENTERIC CRYPTOSPORIDIOSIS IN PEDIATRIC HIV-INFECTION

Background: Enteric cryptosporidiosis is a frequent problem in adults with human immunodeficiency virus (HIV) infection, but little is known of its features in children. The aim of this study was to investigate the incidence and the clinical features of cryptosporidiosis in HIV-i nfected children. Methods: Thirty-five children with symptomatic HIV i nfection were screened every 2 months, and in case of diarrhea, for th e presence of Cryptosporidium. Intestinal function tests were performe d, and the fecal osmotic gap was measured in children with cryptospori diosis. Results: Seventy episodes of diarrhea occurred in 16 children in a median period of 17 months. Cryptosporidium was detected in five cases, all with full-blown acquired immunodeficiency syndrome. Cryptos poridiosis was significantly more protracted than any other form of di arrhea and was associated with dehydration and severe weight loss. Int estinal function was not modified during cryptosporidiosis. Osmotic ga p values were consistent with secretory rather than osmotic diarrhea. In four cases, recovery was observed without specific treatment.Conclu sions: Enteric cryptosporidiosis is a severe problem in advanced stage s of HIV infection. It does not induce intestinal malabsorption. It in duces diarrhea of secretory type. Recovery may be observed independent ly of therapy.