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Cryptosporidiosis in HIV — DTM&H MCQ

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ModerateProtozoal InfectionsCryptosporidiosis in HIVDTM&H

A 5-year-old HIV-positive child in Bangladesh presents with chronic watery diarrhoea lasting 6 weeks and failure to thrive. Modified acid-fast stain shows round oocysts measuring 4-6 µm. What is the most important management step?

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Correct answer: B — Initiation of antiretroviral therapy

The 4-6 µm acid-fast oocysts indicate Cryptosporidium. In HIV-positive children, the most important intervention is ART to restore immune function, as no antimicrobial reliably eradicates Cryptosporidium in immunocompromised patients. Nitazoxanide has modest efficacy in immunocompetent but limited benefit in advanced HIV. Immune reconstitution with ART is the definitive treatment.

Reference: WHO HIV Treatment Guidelines; Manson's Tropical Diseases