Department of Infectious Diseases, Nanshan Hospital, Guangdong Medical College, No. 89, Taoyuan Road, Nanshan District, Shenzhen 518052, China.
Int J Infect Dis. 2011 Dec;15(12):e845-8. doi: 10.1016/j.ijid.2011.08.006. Epub 2011 Oct 12.
Patients with acute-on-chronic liver failure (ACLF) are often highly susceptible to microbial infection due to a depressed immune system. This study was carried out to investigate the prevalence and clinical significance of Cryptosporidium infection in patients with hepatitis B virus (HBV)-associated ACLF in Hunan Province, China.
Fecal samples from 218 patients with HBV-associated ACLF, 122 patients with chronic hepatitis B (CHB), and 140 children with diarrhea were collected; Cryptosporidium infection was detected by auramine-phenol staining, modified acid-fast staining, and the polymerase chain reaction. The clinical characteristics of this parasitic infection in Cryptosporidium-positive ACLF patients were further evaluated.
The prevalence of Cryptosporidium infection in the HBV-associated ACLF patients was 6.0% (13/218), which was markedly higher than that found in CHB patients (0.8%, 1/122) and in children with diarrhea (1.4%, 2/140). Although watery diarrhea was not seen in the 13 Cryptosporidium-positive ACLF patients, eight (61.5%) of them had diarrhea. Moreover, our investigation showed that Cryptosporidium infection was not associated with the severity of the disease in ACLF patients.
The prevalence of Cryptosporidium infection is high among patients with HBV-associated ACLF and might be a significant cause of diarrhea in this population.
由于免疫系统受到抑制，伴有慢加急性肝衰竭（ACLF）的患者通常极易受到微生物感染。本研究旨在调查中国湖南省乙型肝炎病毒（HBV）相关 ACLF 患者中隐孢子虫感染的流行率和临床意义。
收集了 218 例 HBV 相关 ACLF 患者、122 例慢性乙型肝炎（CHB）患者和 140 例腹泻儿童的粪便样本；采用金胺-苯酚染色、改良酸染色和聚合酶链反应检测隐孢子虫感染。进一步评估了隐孢子虫阳性 ACLF 患者中这种寄生虫感染的临床特征。
HBV 相关 ACLF 患者中隐孢子虫感染的流行率为 6.0%（13/218），明显高于 CHB 患者（0.8%，1/122）和腹泻儿童（1.4%，2/140）。虽然在 13 例隐孢子虫阳性 ACLF 患者中未观察到水样腹泻，但其中 8 例（61.5%）有腹泻。此外，我们的调查表明，隐孢子虫感染与 ACLF 患者疾病的严重程度无关。
HBV 相关 ACLF 患者中隐孢子虫感染的流行率较高，可能是该人群腹泻的重要原因。
