Impact of protease inhibitors on the outcome of human immunodeficiency virus-infected patients with chronic diarrhea

Edmund J. Bini, Jonathan Cohen

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

Abstract

OBJECTIVE: The effect of protease inhibitors on the outcome of chronic HIV-related diarrhea is unknown. The aim of this study was to compare the response to treatment of chronic HIV-related diarrhea, recurrence of diarrhea, and survival in a large cohort of individuals taking protease inhibitors to the outcome in similar patients not receiving protease inhibitors. METHODS: We reviewed the medical records of all patients referred between October 1993 and October 1996 at Belle, vue Hospital for endoscopic evaluation of chronic HIV-related diarrhea after negative stool examination. Only patients presenting after December 1995 received protease inhibitor therapy. Follow-up data were obtained from chart review and direct telephone contact. The success of antidiarrheal therapy was compared between protease inhibitor and nonprotease inhibitor groups for patients receiving pathogen- specific therapy and for those with no pathogens found on endoscopy. RESULTS: Two hundred eighty-two of 307 patients evaluated for chronic diarrhea were followed for a mean of 69.9 ± 34.1 weeks. Patients receiving protease inhibitors had a significantly higher rate of successful response to antidiarrheal therapy (62.0% vs 33.5%, p < 0.001). Protease inhibitors were associated with a significant decrease in stool frequency (4.8 ± 4.5 vs 3.4 ± 4.6 bowel movements per day, p = 0.01), an increase in weight (2.4 ± 5.9 vs -1.6 ± 6.2 kg, p < 0.001), a decrease in recurrence of diarrhea (34.8% vs 15.3%, p = 0.02), and a longer mean survival (148 vs 118 weeks, p = 0.002). CONCLUSIONS: Protease inhibitors significantly improve the outcome of antidiarrheal therapy and survival in patients with chronic HIV-associated diarrhea.

Original languageEnglish
Pages (from-to)3553-3559
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume94
Issue number12
DOIs
StatePublished - Dec 1999
Externally publishedYes

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