Manabe Y C, Clark D P, Moore R D, Lumadue J A, Dahlman H R, Belitsos P C, Chaisson R E, Sears C L
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clin Infect Dis. 1998 Sep;27(3):536-42. doi: 10.1086/514701.
Although 10%-15% of patients with AIDS in the United States may acquire cryptosporidium infection, little data exist on clinical or histological characteristics that differentiate clinical outcomes. A case-control study of 83 HIV-positive adult patients with cryptosporidiosis was conducted, as was a histopathologic review of data on gastrointestinal biopsy specimens from 30 patients. Four clinical syndromes were identified: chronic diarrhea (36% of patients), choleralike disease (33%), transient diarrhea (15%), and relapsing illness (15%). A multivariate analysis of data for cases and controls revealed that acquiring cryptosporidiosis was associated with the presence of candidal esophagitis (odds ratio [OR], 2.53; P < .002) and Caucasian race (OR, 6.71; P = .0001) but not with sexual orientation. Cases had a significantly shorter duration of survival from the time of diagnosis than did controls (240 vs. 666 days, respectively; P = .0004), which was independent of sex, race, or or injection drug use. Antiretroviral use was protective against disease (OR, 0.072; P = .0001). All four clinical syndromes were represented among the histological data. There was no statistically significant correlation between histological intensity of infection and clinical severity of illness.
在美国，尽管10% - 15%的艾滋病患者可能感染隐孢子虫，但关于区分临床结局的临床或组织学特征的数据却很少。对83例HIV阳性的隐孢子虫病成年患者进行了病例对照研究，并对30例患者的胃肠道活检标本数据进行了组织病理学回顾。确定了四种临床综合征：慢性腹泻（36%的患者）、霍乱样疾病（33%）、短暂性腹泻（15%）和复发性疾病（15%）。对病例和对照数据的多变量分析显示，感染隐孢子虫与念珠菌性食管炎的存在（比值比[OR]，2.53；P < 0.002）和白种人种族（OR，6.71；P = 0.0001）相关，但与性取向无关。病例从诊断时起的存活时间明显短于对照（分别为240天和666天；P = 0.0004），这与性别、种族或注射吸毒无关。使用抗逆转录病毒药物对疾病有保护作用（OR，0.072；P = 0.0001）。所有四种临床综合征都在组织学数据中有所体现。感染的组织学强度与疾病的临床严重程度之间没有统计学上的显著相关性。
