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Clinical Microbiology Reviews, January 2002, p. 145-154, Vol. 15, No. 1
0893-8512/02/$04.00+0     DOI: 10.1128/CMR.15.1.145-154.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Epidemiology and Clinical Features of Cryptosporidium Infection in Immunocompromised Patients

Paul R. Hunter1* and Gordon Nichols2

School of Medicine, Health Policy and Practice, University of East Anglia, Norwich,1 Environmental Surveillance Unit, PHLS Communicable Disease Surveillance Centre, London, United Kingdom2

Cryptosporidium spp. are a major cause of diarrheal disease in both immunocompetent and immunodeficient individuals. They also cause waterborne disease in both the United States and United Kingdom. Studies on the mechanisms of immunity to cryptosporidiosis indicate the importance of the T-cell response. The spectrum and severity of disease in immunocompromised individuals with cryptosporidiosis reflect this importance since the most severe disease is seen in individuals with defects in the T-cell response. The most commonly studied group is that of patients with AIDS. These patients suffer from more severe and prolonged gastrointestinal disease that can be fatal; in addition, body systems other than the gastrointestinal tract may be affected. The widespread use of antiretroviral therapy does appear to be having a beneficial effect on recovery from cryptosporidiosis and on the frequency of infection in human immunodeficiency virus-positive patients. Other diseases that are associated with increased risk of severe cryptosporidiosis, such as primary immunodeficiencies, most notably severe combined immunodeficiency syndrome, are also predominantly associated with T-cell defects. Of the remaining groups, children with acute leukemia seem to be most at risk from cryptosporidiosis. There is less evidence of severe complications in patients with other malignant diseases or in those receiving immunosuppressive chemotherapy.

* Corresponding author. Mailing address: School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, United Kingdom. Phone: 44 (0) 1603 591004. Fax: 44 (0) 1603 593752. E-mail: paul.hunter{at}uea.ac.uk.

Clinical Microbiology Reviews, January 2002, p. 145-154, Vol. 15, No. 1
0893-8512/02/$04.00+0     DOI: 10.1128/CMR.15.1.145-154.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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