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CRYPTOSPORIDIOSIS IN HIV-INFECTED VENEZUELAN ADULTS IS STRONGLY ASSOCIATED WITH ACUTE OR CHRONIC DIARRHEA

A cross-sectional study was undertaken to determine the prevalence of cryptosporidiosis and its clinical and laboratory pattern in Venezuelan HIV-infected patients (N = 397). At enrollment, they underwent thorough clinical history and physical examination and provided stool specimens for the identification of Cryptosporidium sp. and other parasites. Cryptosporidium sp. was identified in 59 subjects (15%). This infection was strongly associated with acute and chronic diarrhea, weight loss, CD4⁺ counts below 100 cells/mm³, older age in patients with leukopenia, and more than 5 stools per day when CD4⁺ counts were below 100 cells/mm³. In addition, patients with Cryptosporidium infection were less likely to be coinfected with Isospora belli (OR = 0.05, P = 0.001). In fact, results of the current study confirm the worldwide importance of cryptosporidiosis as a clinically significant opportunistic infection associated with an advanced stage of immunosuppression.

Received April 24, 2004. Accepted for publication January 19, 2005.

Acknowledgments: We would like to thank Mrs. Isbelia Rada, our laboratory technician. The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.

Financial support: This study was supported by a grant from the Consejo de Desarrollo Cientifico y Humanistico (CDCH) of the Universidad Central de Venezuela.

^* Address correspondence to Gabriela Certad, Cátedra de Parasitología, Escuela de Medicina, "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela. E-mail: gfombo{at}cantv.net

Authors’ addresses: Gabriela Certad, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: gfombo{at}cantv.net. Alejandro Arenas-Pinto, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: AArenas-Pinto{at}gum.ucl.ac.uk. Leonor Pocaterra, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: lapocaterra{at}cantv.net. Giuseppe Ferrara, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: picho99{at}cantv.net. Julio Castro, Unidad de Investigación quirúrgica, Hospital Vargas de Caracas, San José Caracas, Venezuela, Telephone: 58-212-908-04-16, E-mail: jcastrom{at}cantv.net. Andreina Bello, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: andreinabm2000{at}yahoo.es. Luz Núñez, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: nenagold{at}cantv.net.

Reprint requests: Gabriela Certad, Cátedra de Parasitología, Escuela de Medicina "José María Vargas," Facultad de Medicina, Universidad Central de Venezuela, San José Caracas, Venezuela, Telephone: 58-212-562-95-09, Fax: 58-212-562-99-28, E-mail: gfombo{at}cantv.net.