Foudraine N A, Weverling G J, van Gool T, Roos M T, de Wolf F, Koopmans P P, van den Broek P J, Meenhorst P L, van Leeuwen R, Lange J M, Reiss P
Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
AIDS. 1998 Jan 1;12(1):35-41. doi: 10.1097/00002030-199801000-00005.
A substantial number of patients with advanced HIV infection suffer from intractable diarrhoea. The aim of this study was to evaluate whether potent antiretroviral therapy could alleviate such diarrhoea.
In an open randomized study the effect of the HIV protease inhibitor indinavir in combination with nucleoside analogue reverse transcriptase inhibitors on chronic HIV-related diarrhoea was investigated in 14 late-stage (CD4+ lymphocyte count < or = 50 x 10(6) cells/l) HIV-infected patients. Data concerning stool frequency, stool consistency and antidiarrhoeal drug use were collected in daily diaries over a 24-week period. Endpoints of the study were reduction of stool frequency, improvement of stool consistency, weight gain, and in case of diarrhoea due to Enterocytozoon bieneusi or Cryptosporidium sp. disappearance of these parasites from stool.
Thirteen patients started the study drug indinavir. One patient died after 1 week and one patient withdrew prematurely after 18 weeks. Median stool frequency declined from 5.8 daily at baseline to 2.3 daily after 24 weeks (P=0.04). Stool consistency improved considerably over the study period: before treatment 56% of stools were watery and 0% were formed; at week 24 these figures were 0 and 35%, respectively. Body weight increased significantly with a median increment of 6.6 kg at week 24 (P=0.0006). In two out of six patients with microsporidiosis and both patients with cryptosporidiosis, stools were free of parasites at week 24. Five out of six patients who used non-specific antidiarrhoeal medication on a regular basis prior to the study had ceased to do so at the end.
The use of potent antiretroviral therapy in patients with advanced HIV infection can improve chronic HIV-related diarrhoea and in some cases lead to disappearance of E. bieneusi and Cryptosporidium sp. from the stools.
大量晚期HIV感染患者患有顽固性腹泻。本研究的目的是评估强效抗逆转录病毒疗法是否能缓解此类腹泻。
在一项开放随机研究中，对14例晚期（CD4+淋巴细胞计数≤50×10⁶个细胞/升）HIV感染患者，研究了HIV蛋白酶抑制剂茚地那韦联合核苷类似物逆转录酶抑制剂对慢性HIV相关腹泻的影响。在24周期间，通过每日日记收集有关大便频率、大便稠度和止泻药物使用的数据。研究终点为大便频率降低、大便稠度改善、体重增加，以及因微小隐孢子虫或隐孢子虫属导致腹泻的患者，粪便中这些寄生虫消失。
13例患者开始使用研究药物茚地那韦。1例患者在1周后死亡，1例患者在18周后提前退出。大便频率中位数从基线时的每日5.8次降至24周后的每日2.3次（P=0.04）。在研究期间，大便稠度有显著改善：治疗前56%的大便呈水样，0%成形；在第24周时，这些数字分别为0和35%。体重显著增加，第24周时中位数增加6.6千克（P=0.0006）。在6例微孢子虫病患者中的2例以及2例隐孢子虫病患者中，第24周时粪便中无寄生虫。6例在研究前定期使用非特异性止泻药物的患者中，有5例在研究结束时停止使用。
在晚期HIV感染患者中使用强效抗逆转录病毒疗法可改善慢性HIV相关腹泻，在某些情况下可导致微小隐孢子虫和隐孢子虫属从粪便中消失。
