title: Clinical features & risk factors associated with cryptosporidiosis in HIV infected adults in India.
abstract: OBJECTIVE
  Cryptosporidiosis is a leading cause of protracted, life threatening diarrhoea in HIV infected patients. Although data on prevalence are available for Indian patients, no information on risk factors for transmission exists. We therefore undertook this study to identify risk factors for transmission of cryptosporidiosis in HIV infected adults.
  
  
  METHODS
  Both symptomatic (diarrhoeal) and asymptomatic HIV infected patients were screened for cryptosporidiosis. All Cryptosporidium spp. positive cases were enrolled in the study and interviewed to record socio-demographic information, water supply and animal contact. Data were analysed to study clinical features and potential association with species and genotype.
  
  
  RESULTS
  Of the 28 cryptosporidial infections identified on screening 111 HIV positive patients with diarrhoea, 10 (35.7%) had chronic diarrhoea, 14 (50%) had associated fever and 8 (28.6%) had nausea. Symptomatic patients had a significantly higher number of co-infections with other enteric parasites (P=0.04) than 20 asymptomatics of 423 HIV positive individuals screened. Eleven of 17 (64%) patients with potentially zoonotic infections had diarrhoea. Patients with zoonotic species (64%) also tended to have fever more frequently than those infected with C. hominis (58%). Association between area of residence, rural or urban, water source and contact with animals and acquisition of cryptosporidiosis was not statistically significant.
  
  
  CONCLUSIONS
  Cryptosporidiosis is an important cause of morbidity in HIV infected individuals in India, resulting in chronic diarrhoea. Risk factors for potentially zoonotic transmission of cryptosporidiosis were described in this study, but larger studies need to be done for a clearer understanding of the transmission dynamics of different cryptosporidial species in developing countries.
authors.affiliation: Department of Gastrointestinal Sciences, Christian Medical College Vellore,India.
authors.forename: S S
authors.initials: SS
authors.lastname: Rao Ajjampur
authors.forename: J R
authors.initials: JR
authors.lastname: Asirvatham
authors.forename: Dheepa
authors.initials: D
authors.lastname: Muthusamy
authors.forename: B P
authors.initials: BP
authors.lastname: Gladstone
authors.forename: O C M
authors.initials: OC
authors.lastname: Abraham
authors.forename: Dilip
authors.initials: D
authors.lastname: Mathai
authors.forename: Honorine
authors.initials: H
authors.lastname: Ward
authors.forename: Christine
authors.initials: C
authors.lastname: Wanke
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000635:transmission; D000328:Adult; D000818:Animals; D003457:Cryptosporidiosis / Q000175:diagnosis / Q000209:etiology* / Q000635:transmission; D003458:Cryptosporidium / Q000302:isolation & purification; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population; D014867:Water / Q000469:parasitology
chemical_list: D014867:Water