Matos O, Tomás A, Aguiar P, Casemore D, Antunes F
Disciplina de Protozoologia, Instituto de Higiene e Medicina Tropical, Lisboa, Portugal.
Folia Parasitol (Praha). 1998;45(2):163-6.
We report the findings of a longitudinal observational study on HIV-infected patients grouped by presumed transmission group, who had diarrhoea. The purpose of this study was to assess the prevalence of and factors associated with Cryptosporidium infection on these patients. Modifiied formol-ether concentration followed by modified Ziehl-Neelsen and phenol-auramine/carbol-fuchsin staining techniques were used to identify Cryptosporidium from 465 patients. Cryptosporidiosis was reported in 36/465 (8% and 95% confidence interval 6, 10) patients. Of the positive patients 30 (83%) were men and 6 (17%) women. Prevalence of infection was higher among HIV-seropositive patients whose exposure category was through sexual contact (69%) than among patients in other HIV exposure categories (9%, Standard Z test, P < 0.001). Median CD4+ cell count/mm3 was 120 (range 3-600). Besides diarrhoea, the main clinical manifestations were fever and weight loss in 14 (39%) and 26 (72%) patients, respectively. Cryptosporidium infection was considered to be the first AIDS defining disease in 31% of the patients followed by tuberculosis in 19%, Pneumocystis carinii pneumonia in 14%, Salmonella sepsis in 6%, isosporiasis in 3%, toxoplasmic encephalitis in 3%, leishmaniasis in 3% and Kaposi's sarcoma in 3% of the patients. There was no significant difference (P = 0.82) in survival times for those given folate antagonists to treat other opportunistic infections. The decrease in prevalence of cryptosporidiosis observed from 1994 until May 1997 is not statistically significant (P = 0.11). Most cases of cryptosporidial infection in AIDS patients in Lisbon occurred in those whose HIV infection was assumed to have been acquired by the sexual route (hetero-, homo- and bisexual), with few cases occurring in drug-abusers.
我们报告了一项针对腹泻的HIV感染患者的纵向观察性研究结果，这些患者按假定传播组进行分组。本研究的目的是评估这些患者中隐孢子虫感染的患病率及相关因素。采用改良的甲醛乙醚浓缩法，随后进行改良的齐-尼氏染色法和苯酚金胺/石炭酸品红染色技术，从465例患者中鉴定隐孢子虫。465例患者中有36例（8%，95%置信区间为6%，10%）报告患有隐孢子虫病。阳性患者中，30例（83%）为男性，6例（17%）为女性。通过性接触暴露的HIV血清阳性患者的感染患病率（69%）高于其他HIV暴露类别的患者（9%，标准Z检验，P<0.001）。CD4+细胞计数的中位数为每立方毫米120个（范围为3至600个）。除腹泻外，主要临床表现分别为发热（14例，39%）和体重减轻（26例，72%）。在随访的患者中，31%的患者隐孢子虫感染被认为是第一种艾滋病定义疾病，其次是19%的患者患有结核病，14%的患者患有卡氏肺孢子虫肺炎，6%的患者患有沙门菌败血症，3%的患者患有等孢子球虫病，3%的患者患有弓形虫脑炎，3%的患者患有利什曼病，3%的患者患有卡波西肉瘤。给予叶酸拮抗剂治疗其他机会性感染的患者的生存时间无显著差异（P=0.82）。1994年至1997年5月观察到的隐孢子虫病患病率下降无统计学意义（P=0.11）。里斯本艾滋病患者中的大多数隐孢子虫感染病例发生在那些HIV感染被认为是通过性途径（异性、同性和双性恋）获得的患者中，吸毒者中病例较少。
