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Malabsorption and intensity of infection in AIDS-related cryptosporidiosis.


Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:140.

The purpose of this study was to assess the relationship between intensity of infection (parasite burden) in AIDS- related cryptosporidiosis and the severity of mal- absorption. Intestinal function (2 hour blood D-xylose, Schilling 2 test, and 24 hour stool weight) was assessed in 16 AIDS patients with cryptosporidiosis and was compared to intensity of Cryptosporidium infection as measured by 24 hour oocyst excretion and percent duodenal mucosal infection. Intensity of infection ranged from 3.9 x 10(9) to 2 x 10(4) oocyst/24 hours and 0 to 80% mucosal infection. Normal tests of intestinal function occurred only in patients with low oocyst excretion. Vitamin B12 absorption was negatively correlated with 24 hour oocyst excretion, (r = -0.67; P less than 0.005) and mucosal infection (r= -0.59; P = 0.03), and D-xylose absorption was negatively correlated with mucosal infection (r = -0.45; P = 0.09). There was no relationship between intensity of infection and stool weight. 4 patients with heavy infection who had 90% reduction in oocyst excretion with paromomycin treatment, both Schilling test (mean from 1.2 to 5.6%) and D-xylose test (mean from 12 to 31 mg/dL) improved. In 8 patients with no change in oocyst excretion, intestinal function studies did not change. The severity of intestinal function abnormalities is correlated with intensity of Cryptosporidium infection and this suggests that Cryptosporidium is the cause of malabsorption in these patients. Intensity of infection is important in the pathogenesis of intestinal cryptosporidiosis.

AIDS-Related Opportunistic Infections/*MICROBIOLOGY Enzyme-Linked Immunosorbent Assay Human Immune Sera Microsporida/*ISOLATION & PURIF ABSTRACT


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