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.
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Y C
YC
Manabe
D P
DP
Clark
R D
RD
Moore
J A
JA
Lumadue
H R
HR
Dahlman
P C
PC
Belitsos
R E
RE
Chaisson
C L
CL
Sears
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