Cryptosporidiosis

C. parvum, C. hominis

Treatment

Diagnosis of cryptosporidiosis is made in PLWH with chronic diarrhea, mostly in cases with CD4 count < 100 cells/μL by immunofluorescence, acid fast stain, cryptosporidium antigen or PCR of stools or tissue. If the diarrhea lasts > 4 weeks, the diagnosis of cryptosporidiosis is an AIDS defining illness

Mainstay of therapy is the induction of ART to restore immune competence with CD4 count > 100 cells/μL
Additional measures are symptomatic treatment, rehydration and electrolyte management
The following antiprotozoal therapies can be used additively to cART in severe cases, but are not sufficient to achieve protozoal eradication without immune restoration

Drug / Dose Comments
nitazoxanide 
500-1000 mg bid po
14 days
OR
paromomycin 500 mg qid po
14-21 days