Correa AL, Ramratnam B, Calva J, Sifuentes J, Flanigan T, Sierra Madero J; International Conference on AIDS.

Int Conf AIDS. 1996 Jul 7-12; 11: 447 (abstract no. Pub.B.1056).

Instituto Nacional de la Nutricion, Mexico D.F., Mexico. Fax: (525) 513 0010.

Objective: To describe and analyze retrospectively the clinical manifestations and course of gastrointestinal disease associated with Cryptosporidium in HIV-infected patients. Methods: Review of all charts of patients with diagnosis of cryptosporidiosis and HIV infection between 1988 and 1994 at Instituto Nacional de Nutricion in Mexico City. Demographic information, clinical presentation, course of the disease and treatment used were recorded. Results: During the study period 72 patients with Cryptosporidiosis were included. The most common risk factor for HIV infection was homosexuality (40 patients). Diagnosis of HIV infection and Cryptosporidium was simultaneous in 27 patients in whom Cryptosporidium infection was the first AIDS defining illness. Diagnosis of cryptosporidiosis was made in stool exam in 51 patients, intestinal biopsy in 6 and in 15 both tests were positive. At the time of diagnosis, 70 patients had diarrhea, one had abdominal pain and the other was asymptomatic. Other common symptoms were abdominal pain (62%), vomiting (26%) and fever (36%). Fifty six patients (77%) had lost a mean of 14 kg in a mean of 8.5 months. Some patients had more than one pathogen isolated, CMV was present in the intestinal biopsy in 11 cases, and Isospora in 6. CD4 cell count determinations were available in 21 patients, in whom the mean count was 108+ cells/mm plus or minus 140.7. In 66% of patients the count was lower than 100. In spite of treatment the parasite persisted in stools of 13 of 23 patients (56%) and diarrhea persisted in 30 of 46 patients (66%). In these patients the mean leukocyte count, lymphocytes and CD4 cells were significantly lower (p is less than 0.05) than in patients whose diarrhea subsided. Of the 72 patients, only in 24 there was an adequate follow up. In this group of patients, survival at 9 months was 50%. Factors associated with a longer survival were Hemoglobin greater than 10g/dl, Total lymphocyte count greater than 1000/ mm3 and remission of diarrhea. Conclusions: The main manifestations of gastrointestinal infection with Cryptosporidium were abdominal pain and diarrhea. Persistence of diarrhea was associated with a lower leukocyte count, lymphocytes and CD4 cells. Treatment with spiramycin-metronidazol or other macrolides did not show any clinical benefit of eradication of the parasite.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Animals
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes
• Cryptosporidiosis
• Cryptosporidium
• Diarrhea
• Feces
• HIV Infections
• HIV Seropositivity
• Humans
• Isospora
• Mexico
• Research
• Risk Factors

Other ID:

• 96925505

UI: 102221404

From Meeting Abstracts