title: Cryptosporidiosis in HIV/AIDS patients in Kenya: clinical features, epidemiology, molecular characterization and antibody responses.
abstract: We investigated the epidemiological and clinical features of cryptosporidiosis, the molecular characteristics of infecting species and serum antibody responses to three Cryptosporidium-specific antigens in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Kenya. Cryptosporidium was the most prevalent enteric pathogen and was identified in 56 of 164 (34%) of HIV/AIDS patients, including 25 of 70 (36%) with diarrhea and 31 of 94 (33%) without diarrhea. Diarrhea in patients exclusively infected with Cryptosporidium was significantly associated with the number of children per household, contact with animals, and water treatment. Cryptosporidium hominis was the most prevalent species and the most prevalent subtype family was Ib. Patients without diarrhea had significantly higher serum IgG levels to Chgp15, Chgp40 and Cp23, and higher fecal IgA levels to Chgp15 and Chgp40 than those with diarrhea suggesting that antibody responses to these antigens may be associated with protection from diarrhea and supporting further investigation of these antigens as vaccine candidates.
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya jwanyir1@jhmi.edu hward@tuftsmedicalcenter.org.
authors.forename: Jane W
authors.initials: JW
authors.lastname: Wanyiri
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Henry
authors.initials: H
authors.lastname: Kanyi
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Samuel
authors.initials: S
authors.lastname: Maina
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: David E
authors.initials: DE
authors.lastname: Wang
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Aaron
authors.initials: A
authors.lastname: Steen
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Paul
authors.initials: P
authors.lastname: Ngugi
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Timothy
authors.initials: T
authors.lastname: Kamau
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Tabitha
authors.initials: T
authors.lastname: Waithera
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Roberta
authors.initials: R
authors.lastname: O'Connor
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Kimani
authors.initials: K
authors.lastname: Gachuhi
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Claire N
authors.initials: CN
authors.lastname: Wamae
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Mkaya
authors.initials: M
authors.lastname: Mwamburi
authors.affiliation: Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts; Center of Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; Center of Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya jwanyir1@jhmi.edu hward@tuftsmedicalcenter.org.
authors.forename: Honorine D
authors.initials: HD
authors.lastname: Ward
mesh_terms: D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D000953:Antigens, Protozoan / Q000097:blood*; D060085:Coinfection; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D003458:Cryptosporidium / Q000472:pathogenicity* / Q000502:physiology; D003967:Diarrhea / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D005191:Family Characteristics; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D057805:Pets
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D007070:Immunoglobulin A; D007074:Immunoglobulin G