High Clinical Burden of Cryptosporidium spp. in Adult Patients with Acquired Immunodeficiency in Ghana

There is a paucity of information on the prevalence, risk factors, and clinical correlates of people living with HIV (PLWH) who are co-infected with <i>Cryptosporidium</i> spp. in the post-combined antiretroviral therapy era in Ghana. To provide such data, in this observational study, stool samples of 640 HIV-positive and 83 HIV-negative individuals in Ghana were screened for <i>Cryptosporidium</i> spp. Additionally, sociodemographic parameters, clinical symptoms, medication intake, and immunological parameters were assessed. The prevalence of <i>Cryptosporidium</i> spp. was 11.8% (n = 73) in HIV-positive and 1.2% (n = 1) in HIV-negative participants (<i>p</i> < 0.001). Within the group of HIV-positive participants, the prevalence reached 26.0% in patients with CD4+ T cell counts below 200 cells/µL and 46.2% in the subgroup with CD4+ T cell counts below 50 cells/µL. The frequencies of the clinical manifestation of weight loss and gastrointestinal symptoms were significantly higher in patients with <i>Cryptosporidium</i> spp. compared to those without co-infection (45.8% vs. 21.4%, <i>p</i> < 0.001 and 22.2% vs. 12.2%, <i>p</i> = 0.031, respectively). In the modern post-cART era, the acquisition of <i>Cryptosporidium</i> spp. among PLWH in Ghana is driven largely by the degree of immunosuppression. Access to cART and screening for <i>Cryptosporidium</i> spp. as part of routine care might help control and reduce the burden of the infection.