Cryptosporidiosis in patients with AIDS: correlates of disease and survival.
Although 10%-15% of patients with AIDS in the United States may acquire cryptosporidium infection, little data exist on clinical or histological characteristics that differentiate clinical outcomes. A case-control study of 83 HIV-positive adult patients with cryptosporidiosis was conducted, as was a histopathologic review of data on gastrointestinal biopsy specimens from 30 patients. Four clinical syndromes were identified: chronic diarrhea (36% of patients), choleralike disease (33%), transient diarrhea (15%), and relapsing illness (15%). A multivariate analysis of data for cases and controls revealed that acquiring cryptosporidiosis was associated with the presence of candidal esophagitis (odds ratio [OR], 2.53; P < .002) and Caucasian race (OR, 6.71; P = .0001) but not with sexual orientation. Cases had a significantly shorter duration of survival from the time of diagnosis than did controls (240 vs. 666 days, respectively; P = .0004), which was independent of sex, race, or or injection drug use. Antiretroviral use was protective against disease (OR, 0.072; P = .0001). All four clinical syndromes were represented among the histological data. There was no statistically significant correlation between histological intensity of infection and clinical severity of illness.
Manabe
Y C
YC
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clark
D P
DP
Moore
R D
RD
Lumadue
J A
JA
Dahlman
H R
HR
Belitsos
P C
PC
Chaisson
R E
RE
Sears
C L
CL
D017088:AIDS-Related Opportunistic Infections / Q000401:mortality* / Q000469:parasitology / Q000473:pathology; D000328:Adult; D000368:Aged; D000818:Animals; D016022:Case-Control Studies; D015331:Cohort Studies; D003457:Cryptosporidiosis / Q000150:complications / Q000401:mortality* / Q000469:parasitology / Q000473:pathology; D003458:Cryptosporidium / Q000302:isolation & purification; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis