| Cryptosporidium is one of the major causes of diarrhea in HIV-positive patients. The aim of this study is
to systematically review and meta-analyze the prevalence of Cryptosporidium in these patients. PubMed, Science
Direct, Google Scholar, Web of Science, Cochrane and Ovid databases were searched for relevant studies dating from
the period of 1 January 2000 to 31 December 2017. Data extraction for the included studies was performed independently
by two authors. The overall pooled prevalence was calculated and subgroup analysis was performed on diagnostic
methods, geographical distribution and study population. Meta-regression was performed on the year of
publication, proportion of patients with diarrhea, and proportion of patients with CD4 < 200 cells/mL. One hundred
and sixty-one studies and 51,123 HIV-positive participants were included. The overall pooled prevalence of Cryptosporidium
infection in HIV-positive patients was 11.2% (CI95%: 9.4%–13.0%). The pooled prevalence was estimated
to be 10.0% (CI95%: 8.4%–11.8%) using staining methods, 13.5% (CI95%: 8.9%–19.8%) using molecular
methods, and 26.3% (CI95%: 15.0%–42.0%) using antigen detection methods. The prevalence of Cryptosporidium
in HIV patients was significantly associated with the country of study. Also, there were statistical differences between
the diarrhea, CD4 < 200 cells/mL, and antiretroviral therapy risk factors with Cryptosporidiosis. Thus, Cryptosporidium
is a common infection in HIV-positive patients, and safe water and hand-hygiene should be implemented to
prevent cryptosporidiosis occurrence in these patients. |