Prevalence and clinical significance of Cryptosporidium infection in patients with hepatitis B virus-associated acute-on-chronic liver failure

Int J Infect Dis. 2011 Dec;15(12):e845-8. doi: 10.1016/j.ijid.2011.08.006. Epub 2011 Oct 12.

Abstract

Background: Patients with acute-on-chronic liver failure (ACLF) are often highly susceptible to microbial infection due to a depressed immune system. This study was carried out to investigate the prevalence and clinical significance of Cryptosporidium infection in patients with hepatitis B virus (HBV)-associated ACLF in Hunan Province, China.

Methods: Fecal samples from 218 patients with HBV-associated ACLF, 122 patients with chronic hepatitis B (CHB), and 140 children with diarrhea were collected; Cryptosporidium infection was detected by auramine-phenol staining, modified acid-fast staining, and the polymerase chain reaction. The clinical characteristics of this parasitic infection in Cryptosporidium-positive ACLF patients were further evaluated.

Results: The prevalence of Cryptosporidium infection in the HBV-associated ACLF patients was 6.0% (13/218), which was markedly higher than that found in CHB patients (0.8%, 1/122) and in children with diarrhea (1.4%, 2/140). Although watery diarrhea was not seen in the 13 Cryptosporidium-positive ACLF patients, eight (61.5%) of them had diarrhea. Moreover, our investigation showed that Cryptosporidium infection was not associated with the severity of the disease in ACLF patients.

Conclusions: The prevalence of Cryptosporidium infection is high among patients with HBV-associated ACLF and might be a significant cause of diarrhea in this population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China / epidemiology
  • Cryptosporidiosis / complications
  • Cryptosporidiosis / epidemiology*
  • Cryptosporidiosis / parasitology
  • Cryptosporidium / genetics
  • Cryptosporidium / isolation & purification*
  • Diarrhea / parasitology
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / epidemiology*
  • End Stage Liver Disease / virology
  • Feces / parasitology
  • Female
  • Follow-Up Studies
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / epidemiology*
  • Hepatitis B, Chronic / virology
  • Humans
  • Infant
  • Liver Failure, Acute / complications
  • Liver Failure, Acute / epidemiology*
  • Liver Failure, Acute / virology
  • Male
  • Middle Aged
  • Prevalence