Cryptosporidium spp. são importantes causas de doenças entéricas em humanos, mas podem também ser encontrados em animais. O presente estudo descreve a frequência relativa de diversas espécies de Cryptosporidium em amostras de humanos da cidade de São Paulo, Brasil, obtidas de janeiro a julho de 2007. Análises de sequências de produtos de nested PCR direcionadas ao genes codificadores da menor unidade ribosomal e da proteina de parede de oocistos revelaram 17 (63,0%) isolados de C. hominis, quatro (14,8%) C. parvum, cinco (18,5%) C. felis, e um (3,7%) C. canis. Estes resultados sugerem que, em ambientes urbanos no Brasil, o genótipo adaptado ao gato pode desempenhar potencial papel na transmissão zoonótica de criptosporidiose, enquanto a transmissão antroponótica da criptosporidiose causada pelo C. hominis parece predominar.

Cryptosporidium spp. are important cause of enteric disease in humans, but may also infect animals. This study describes the relative frequency of several Cryptosporidium species found in human specimens from HIV infected patients in the São Paulo municipality obtained from January to July 2007. Sequence analysis of the products of nested-PCR based on small subunit rRNA and Cryptosporidium oocyst wall protein coding genes revealed 17 (63.0%) isolates of C. hominis, four (14.8%) C. parvum, five (18.5%) C. felis and one (3.7%) C. canis. These findings suggest that, in urban environments of Brazil, the cat adapted C. felis may play a potential role in the zoonotic transmission of cryptosporidiosis whereas the anthroponotic transmission of cryptosporidiosis caused by C. hominis seems to predominate.

Relata-se um caso de paciente com aids e imunodepressão severa que desenvolveu um quadro diarréico pela forma vacuolar do Blastocystis hominis. Utlizou-se da nitazoxanida, um 5 nitrotiazol, de amplo espectro parasitário, com remissão total da sintomatologia e erradicação da parasitose. A nitazoxanida se mostra como uma nova opção no tratamento da blastocistose em indivíduos com aids, porém estudos adicionais devem ser propostos.

We report a case of a patient with AIDS and severe immunosuppression who developed diarrhea due to a vacuolar stage of Blastocystis hominis. The patient was treated with nitazoxanide, a 5-nitrothiazole broad-spectrum antiparasitic agent. We obtained complete remission of symptoms and eradication of the parasite. Nitazoxanide is a new treatment option for blastocystosis in AIDS patients. Further studies to test its efficacy are needed.

Intestinal parasites in HIV infected patients are a compelling issue in epidemiological settings with high prevalence of these parasites. The present study reviewed frequencies of diagnosis for common intestinal parasites in HIV infected patients in association with sex, age, HIV risk behavior and CD4 lymphocyte count. Patients with confirmed HIV diagnosis and positive routine stool examination between January and December 2000 were selected. Diagnostic methods for Cyclospora cayetanensis and microsporidia were not included in the routine stool examination. A total of 146 patients had one or more positive samples (median 1.5) with age ranging between 2-75 years (mean: 34). Most of them were male (70.5%) and 53.6% had a CD4 count > 200 cells/mm³ (median: 158.5 cells/mm³). Endolimax nana (27.4%), Entamoeba coli (22.6%), Strongyloides stercoralis (21.9%), Giardia lamblia (13.0%), Isospora belli (12.3%), Ascaris lumbricoides (8.2%), Cryptosporidium parvum (6.8%) were the most frequent parasites diagnosed in this group. G. lamblia was more common in children with vertically transmitted HIV and men who have sex with men. No significant associations were found in relation to sex and age. Patients with CD4 count < 200 cells/mm³ presented lower prevalence of non-pathogenic parasites (e.g. E. nana OR 0.46 and E. coli OR 0.33) but had more pathogenic parasites diagnosed such as S. stercoralis (OR 3,9) and I. belli (OR 3,5) in relation to those HIV-infected individuals with CD4 count e•200 cells/mm³. These results underscore the importance of S. stercoralis in AIDS patients; the decrease in C. parvum prevalence in relation to previous reports from our institution before the routine use of HAART; local differences in parasite profiles in comparison to other epidemiological settings as well as changes in the proportion of diagnosis for pathogenic and non-pathogenic parasites according to the immune compromise due to HIV infection