La criptosporidiosis constituye una infección oportunista relevante en individuos inmunocomprometidos, especialmente en pacientes con VIH en estadios avanzados. Se analizó la epidemiología de la diarrea causada por Cryptosporidium spp. en personas seropositivas atendidas en la Unidad de Atención Integral de VIH del Hospital Básico Yantzaza (Ecuador), entre octubre 2023 y marzo 2024. Se incluyeron 133 pacientes, cuyas muestras fecales fueron procesadas mediante tinción de Ziehl-Neelsen para la identificación de ooquistes y qPCR para la detección de ADN parasitario. El análisis estadístico se realizó con la prueba de chi cuadrado, considerando un nivel de confianza del 95 % (α = 0,05). Del total de participantes, 84 (63,2 %) presentaron diarrea; de ellos, 58 (69,0 %) mostraron ooquistes de Cryptosporidium spp. Se evidenció asociación significativa entre la presencia de formas evolutivas del parásito y diarrea (p = 0,000). No se encontró asociación significativa con sexo, edad, nivel educativo, ni condición socioeconómica; pero si, con la etnia, provincia de procedencia, carga viral, recuento de linfocitos T, grado de inmunosupresión y adherencia al tratamiento (p = 0,000). Estos hallazgos subrayan la importancia de la criptosporidiosis como marcador clínico en pacientes inmunocomprometidos y la necesidad de fortalecer estrategias diagnósticas y terapéuticas en este grupo vulnerable.
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