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ASYMPTOMATIC CRYPTOSPORIDIUM HOMINIS INFECTION AMONG HUMAN IMMUNDEFICIENCY VIRUS–INFECTED PATIENTS IN TANZANIA

ERIC R. HOUPTDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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OLUMA Y. BUSHENDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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NOEL E. SAMDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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ANITA KOHLIDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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AMON ASGHARPOURDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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CHERIE T. NGDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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DAVID P. CALFEEDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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RICHARD L. GUERRANTDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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VENANCE MARODivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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SENDUI OLE-NGUYAINEDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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JOHN F. SHAODivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York

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Few data exist on the relative importance of individual Cryptosporidium species in acquired immunodeficiency syndrome cryptosporidiosis. We characterized 127 inpatients infected with human immunodeficiency virus (HIV) in Tanzania for their CD4 cell count and by stool analysis, including Cryptosporidium immunofluorescence and polymerase chain reaction-restriction fragment length polymorphism. Cryptosporidium was detected in patients both with and without diarrheal symptoms (defined as ≥ 3 liquid stools/day, 11 of 61 versus 11 of 66; P = not significant) and was a marker for low CD4 cell count (median = 124/μL versus 212/μL in Cryptosporidium-negative patients; P < 0.04). Cryptosporidium hominis was the predominant species in this region and was associated with a longer duration of symptoms, a higher rate of asymptomatic infection, and a lower CD4 cell count versus C. parvum-infected patients (P < 0.05). This study suggests there may be important differences in the natural history of Cryptosporidium infection in HIV-infected persons depending on parasite species.

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