Panel’s Recommendations

Reduce risk of Cryptosporidium infection by avoiding drinking water from public swimming pools and other bodies of recreational water (AIII), touching farm animals (BIII), and having contact with known Cryptosporidium-infected individuals (AIII). Combination antiretroviral therapy (cART) to prevent or reverse severe immune deficiency is the primary modality for preventing chronic Cryptosporidium infection in HIV-infected children (AII*). Effective cART is the primary initial treatment for Cryptosporidium infections in HIV-infected children and adults (AII*). Nitazoxanide can be considered in immunocompromised HIV-infected children in conjunction with cART for treatment of Cryptosporidium infection (BII*). Supportive care with hydration, correction of electrolyte abnormalities, and nutritional supplementation should be provided (AIII).

Rating of Recommendations: A = Strong; B = Moderate; C = Optional

Rating of Evidence: I = One or more randomized trials in children^† with clinical outcomes and/or validated endpoints; I* = One or more randomized trials in adults with clinical outcomes and/or validated laboratory endpoints with accompanying data in children^† from one or more well-designed, nonrandomized trials or observational cohort studies with long-term clinical outcomes; II = One or more well-designed, nonrandomized trials or observational cohort studies in children^† with long-term outcomes; II* = One or more well-designed, nonrandomized trials or observational studies in adults with long-term clinical outcomes with accompanying data in children^† from one or more similar nonrandomized trials or cohort studies with clinical outcome data; III = Expert opinion

^†Studies that include children or children/adolescents, but not studies limited to post-pubertal adolescents.