Cryptosporidiosis in AIDS: Correlates of disease and survival

Y. C. Manabe, D. P. Clark, R. D. Moore, J. Lumadue, H. Dahlman, R. E. Chaisson, C. L. Sears

Research output: Contribution to journalArticlepeer-review

Abstract

Cryptosporidial infection in HTV ranges from a self-limited disease to a chronic, cholera-like illness and develops in 10-15% of AIDS patients in the US. Little data exists on clinical or histologie characteristics which differentiate clinical outcomes. A retrospective, case-control review of 88 HIV-positive patients with cryptosporidiosis and histopathologic review of the 32 patients with gastrointestinal biopsies was conducted. 86% of the patients had an ATDS-defining illness other than cryptosporidiosis at the time of diagnosis. Four clinical syndromes were identified: chronic diarrhea (37%), relapsing illness (14%), cholera-like disease (33%), and disease that resolves (16%). Black patients and intravenous drug users (IVDU) had a shorter ut not sexual orientation. Cases had a significantly shorter duration of survival from diagnosis than controls (277 vs. 424 days, p<0.01). Antiretroviral use was protective against disease independent of CD4 count (OR=0.07, p<0.01). All 4 clinical syndromes were represented among the histologic data. Nevertheless, patients with choleralike or relapsing disease were most likely to have upper and lower GI biopsies. Cryptosporidial organisms could be identified throughout the gut in such patients. The most common presentations of cryptosporidiosis in AIDS are chronic diarrhea and cholera-like disease. While race is associated with acquisition of disease, while anitretroviral use is protective. Black race and IVDU correlated with shortened survival implying that host factors may alter the subsequent clinical course. Prospective studies to validate these results are needed.

Original languageEnglish (US)
Pages (from-to)359
Number of pages1
JournalClinical Infectious Diseases
Volume25
Issue number2
StatePublished - 1997

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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