Cryptosporidiosis in HIV-seropositive patients.
The incidence of cryptosporidiosis in our unit has increased over the last 6 years, being diagnosed in approximately 5 per cent of all patients with HIV infection and in 21 per cent of those with AIDS, but a marked seasonal variation occurs. We have studied the course of the infection in 128 patients and identified four clinical patterns of disease: transient (28.7 per cent), chronic (59.7 per cent), fulminant (7.8 per cent) and asymptomatic (3.9 per cent). Transient disease occurred in patients with a wide range of CD4 lymphocyte counts, but was more common in less immunosuppressed patients. Fulminant disease, defined by the passage of more than 2 l of stool/day from the time of presentation, only occurred in patients with a CD4 count less than 50/mm3. This group had lost more than 7 kg in weight at presentation and more commonly had other intercurrent gastrointestinal infections. They survived for a median of only 5 weeks, compared with 20 weeks for those with chronic diarrhoea and 36 weeks for those with transient infection. The survival was unaffected by any treatment other than zidovudine. Cryptosporidiosis in HIV-infected individuals is a heterogeneous disease.
HIV/GUM Unit, Westminster Hospital, London.
C
C
Blanshard
A M
AM
Jackson
D C
DC
Shanson
N
N
Francis
B G
BG
Gazzard
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000453:epidemiology; D015496:CD4-Positive T-Lymphocytes; D003457:Cryptosporidiosis / Q000150:complications* / Q000453:epidemiology; D003967:Diarrhea / Q000469:parasitology; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D008131:London / Q000453:epidemiology; D008297:Male; D012621:Seasons