PREVALENCE OF CRYPTOSPORIDIOSIS IN HIV/AIDS PATIENTS IN A TERTIARY CARE HOSPITAL IN WEST BENGAL

BACKGROUND Cryptosporidium is one of the most common intestinal pathogen throughout the world and is the most common waterborne pathogen associated with diarrhoea in AIDS patients. These parasites draw attention as an emerging pathogen with spread of AIDS pandemic. We undertook a study to find the prevalence of Cryptosporidiosis in HIV/AIDS and its correlation with CD4 count. METHODS In this study of one year duration 80 HIV seropositive patients were included ( Fifty with diarrhoea and thirty without diarrhoea). Control group consisted of 80 HIV seronegative patients. Thorough history was taken for all enrolled subjects regarding name, age, sex, HIV status, presence/absence of diarrhoea, socio-economic status, source of drinking water and water for other purposes. For the study group history of the presenting complain, associated opportunistic infection, history of tuberculosis and other drug history was taken. A thorough history of the nature of diarrhoea was taken. CD4 count of the enrolled patients was carried out. Stool samples collected from each enrolled patient were examined microscopically by different methods for the presence of cryptosporidium and other ova, cysts and parasites. RESULT Infection was commoner in males being highest in the age group of 30-39 years; 72% acquired HIV infection heterosexually. Chronic diarrhoea was seen in 46.25% of HIV patients whose mean CD4 count was 176.7 cells/mu L. The prevalence of Cryptosporidium in the study group was 12.5%. In HIV positive diarrhoeal group, Cryptosporidium oocysts was found in 20% patients. Isospora was detected in one HIV patient. In the study population, 48.75% of patients had severe immunosuppression with CD4 count = 200 cells/mu L; 70% of cryptosporidium isolation was from severely immunocompromised hosts with CD4 count < 100 cells/mu L. The duration of diarrhoea was inversely proportional to the CD4 count; 80% of patients suffering from cryptosporidiosis used municipality water for drinking. CONCLUSION Cryptosporidiosis is a well-known opportunistic infection in HIV patients, particularly those with chronic diarrhoea and the risk increases with a low CD4 count. However, sexual activities and use of improperly stored or treated drinking water is also a risk factor.