Cryptosporidiosis - Opportunistic Infections
Cryptosporidiosis is a fairly common infection found in the parasite cryptosporidium parvum. It’s very easily transmitted and is found in humans, water, animals, dust and soil.
It’s an unpleasant infection in someone whose immune system has been knocked for six by HIV. Healthy people on the other hand can carry the infection without even knowing about it and if they do get symptoms they can usually fight them off successfully within a few days.
The infection usually attacks the gastrointestinal tract causing severe watery diarrhea and stomach cramps, particularly in the right hand side. Nausea is very common and it can last up to three weeks. In the meantime, because of the diarrhea, weight loss and dehydration can become a major problem.
Diagnosis is usually confirmed by examining a person’s faeces for any sign of the parasite.
Cryptosporidiosis usually affects people whose CD4+ count is less than 300. And if the infection continues in a HIV positive person for more than four weeks they are usually regarded as having full blown AIDS as the body’s immune system just can’t fight it off. Around 30% of people with AIDS at any one time will suffer from it.
In developing countries the rate of cryptosporidiosis is very high because of poor hygiene and the likelihood of contaminated water. Some health agencies recommend drinking bottled water to avoid contamination which is all very well but in countries where water, in general, is in short supply that’s just not an option and the problem keeps getting worse. Generally speaking, increases in the number of cases of HIV infection are going hand in hand with a rise in the number of people with cryptosporidiosis as those with HIV are highly vulnerable to this bacterium.
Unfortunately there are no drugs to prevent cryptosporidiosis or treat it. Several drugs are being tested including the antibiotics paromomycin and azithromycin.
Azithromycin has been shown to have some effect particularly when given intravenously.
Symptoms of the infection, such as diarrhea, can be treated with various drugs including Imodium and Sandostatin and sufferers can be rehydrated intravenously.
So is it a foregone conclusion that someone with HIV will contract cryptosporidiosis? Well, it has to be said that the likelihood is high, particularly if their CD4+ count continues to drop. It could be avoided through general cleanliness. Simple steps like avoiding animal or human faeces and washing hands after going to the toilet, gardening or even handling animals can prevent cross infection.
Swallowing contaminated water or even swimming in it can also cause infection.
Cryptosporidiosis can also be spread through anal and oral sex. So if a person has anal sex, it’s best to avoid oral sex straight afterwards unless the condom is changed.