Pozio E, Rezza G, Boschini A, Pezzotti P, Tamburrini A, Rossi P, Di Fine M, Smacchia C, Schiesari A, Gattei E, Zucconi R, Ballarini P
Laboratory of Parasitology, Istituto Superiore di Sanità, Rome, Italy.
J Infect Dis. 1997 Oct;176(4):969-75. doi: 10.1086/516498.
The natural history of cryptosporidiosis was investigated during a waterborne outbreak among 1731 members of a drug rehabilitation community in Italy; 19.6% of the members were positive for human immunodeficiency virus (HIV). Demographic and clinical information and pre-outbreak serum samples were available. Clinical data were analyzed, stratifying the study population by HIV serostatus and CD4 cell count. The attack rate of clinical cryptosporidiosis was 13.6% among HIV-negative individuals and 30.7% among HIV-positive individuals, although in the latter, it varied according to CD4 cell count. Clinical symptoms and their duration were also related to CD4 cell count. Chronic symptoms were observed in only 16 individuals (15.4%), who all had <150 CD4 cells at the onset of the illness. Among a systematic sample of 198 individuals, 14.1% already had anti-Cryptosporidium antibodies before the outbreak, and 51.2% developed specific antibodies during the outbreak. The development and clinical manifestations of cryptosporidiosis were strongly influenced by the level of HIV-induced immunosuppression.
在意大利一个戒毒社区的1731名成员中发生水源性隐孢子虫病暴发期间，对隐孢子虫病的自然史进行了调查；19.6%的成员人类免疫缺陷病毒（HIV）检测呈阳性。可获取人口统计学和临床信息以及暴发前的血清样本。对临床数据进行了分析，按HIV血清学状态和CD4细胞计数对研究人群进行分层。临床隐孢子虫病的发病率在HIV阴性个体中为13.6%，在HIV阳性个体中为30.7%，不过在后者中，发病率根据CD4细胞计数而有所不同。临床症状及其持续时间也与CD4细胞计数有关。仅16名个体（15.4%）出现慢性症状，这些个体在疾病发作时CD4细胞均<150个。在198名个体的系统样本中，14.1%在暴发前已具有抗隐孢子虫抗体，51.2%在暴发期间产生了特异性抗体。隐孢子虫病的发生和临床表现受到HIV诱导的免疫抑制水平的强烈影响。
