Nituzoxomide in AIDS –
Correct Answer: Cryptosporidiosis
Description: Cryptosporidium is an intracellular protozoan parasite that is associated with self-limited diarrhea in immunocompetent hosts and severe debilitating diarrhea with weight loss and malabsorption in H1V-infected patients.
Treatment of immunocompetent patients
Recovery from Cryptosporidium infection depends largely upon the immune status of the host.
- Immunologically healthy patients
- Usually have a spontaneous recovery within a few weeks and parasitologic cure within a few months without requiring any specific therapy.
When therapy is required, nitazoxanide, a nitrotlziazole benzamide, is the preferred drug in children 1 to 11 years of age and has also been studied in adults :
Treatment in HIV-infected patients
Antiretroviral therapy
For HIV-infected patients, the most important part of therapy is initiating HAART in order to reconstitute immunity.
In such patients, clinical resolution may occur, but it is unclear whether organisms are completely eliminated.
Supportive care
For patients with severe symptoms, antidiarrheal agents and supportive care with enteral or parenteral nutrition can be considered. Repletion of electrolyte losses by either oral or intravenous routes is important in patients who experience significant volume loss associated with severe.
Antimicrobial agents
- If these measures fail, it is reasonable to consider antimicrobial therapy. However, there is limited efficacy of any of the currently available agents. Due to the clinical impact of persistent cryptosporidial infection, the Centers for Disease Control and Prevention suggests a trial of nitazoxanide treatment based on the data below.
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