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1994-10-25
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Document 2953
DOCN M94A2953
TI Etiology, nutritional assessment and management of chronic diarrhea in
24 HIV patients.
DT 9412
AU Wanke C; Pleskow D; DeGirolami P; Federman M; New England Deaconess
Hospital, Boston, MA.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):187 (abstract no. PB0178). Unique
Identifier : AIDSLINE ICA10/94369622
AB OBJECTIVE: We studied 24 male patients (p) with HIV who had chronic
diarrhea. METHODS: Each p had a nutritional survey, stool cultures and
exam including cryptosporidium (cryp) and microsporidium (mic), upper
and lower endoscopy with biopsy, electron microscopy, viral cultures and
quantitative small bowel cultures. RESULTS: P had diarrhea for a mean
(m) of 8.2 months, had a m CD4 count of 121, had lost a m of 12.4% of
their ideal body weight, had a m of 4.6 stools/day, and malabsorbed a m
of 14.4 grams of fat/day on a 100 g fat diet. 10 p had mic, 3 p had
cryp, 1 had campylobacter, 1 had spirochetes and 9 p had no pathogen
identified (npi). P with mic had m CD4 count of 43, m fecal fat of 23.7g
vs. 12.5g for npi (p < 0.02), urine D-xylose of 1.5g vs. 4.6g (p <
0.02), m vitamin B12 of 198pg vs. 620pg (p < 0.007) and m of 8 stools/d
vs. 5 in the npi (p < 0.06). P were randomly assigned to receive one of
two nutritionally complete liquid diets: one with medium chain
triglycerides (MCT) Lipisorb (35% fat, 85% MCT); the other identical
except fats were long chain triglycerides (LCT). After 12 monitored days
of liquid diet only, the MCT group had significantly lower fecal weight
and fat content from baseline and the LCT group (p < 0.01 for all)
decreased stools from 4.6/d to 2.0/d. On d 12, p with mic on MCT had
decreased fecal fat 36% from baseline vs. 15% in LCT (P < 0.01). 4/4 p
with S. intestinalis responded completely to Albendazole therapy, while
4/4 with E. bineusi did not. CONCLUSION: HIV patients with diarrhea and
fat malabsorption may respond to directed therapy of their infection and
nutritional therapy with MCT formula.
DE AIDS-Related Opportunistic Infections/*COMPLICATIONS/THERAPY Chronic
Disease Diarrhea/*ETIOLOGY/THERAPY Enteral Nutrition Food, Formulated
Human HIV Infections/*COMPLICATIONS Malabsorption
Syndromes/ETIOLOGY/THERAPY Male *Nutrition Assessment Nutritional
Requirements Triglycerides CLINICAL TRIAL MEETING ABSTRACT
RANDOMIZED CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).