Prevalence of HIV-related Diarrhea Remains High in Post-HAART Era

By Martha Kerr

Before the advent of highly active antiretroviral therapy (HAART) for HIV infection, the prevalence of disease-associated diarrhea was about 50%. The problem still persists in nearly 40% of patients, according to a study from investigators at New York University.

On Sunday, at Digestive Disease Week 2003, the 104th annual meeting of the American Gastroenterological Association, Dr. Uzma Siddiqui presented her center's findings from a study of 116 HIV-infected patients and 134 controls attending a primary care clinic. The subjects were asked about their bowel status, general health and quality of life. "We excluded patients attending GI clinics to reduce bias," she told Reuters Health.

The investigators found that 38.3% of HIV-infected patients reported having diarrhea in the past month compared with 19.4% of controls. In addition, 26.1% of HIV-positive patients reported having 3 or more bowel movements a day within the past month compared with 5.2% of controls, with similar numbers in each group reporting 3 or more bowel movement per day within the past 6 months. (p < 0.001 for all).

When asked how they described their stools, 19.1% of HIV patients described them as "loose" or "liquid" compared with 7.4% of controls. Over-the-counter anti-diarrheal medication was taken by 14.8% of HIV-infected patients compared with 0.7% of controls.

Dr. Siddiqui reported that responses to quality of life measures revealed that HIV-infected patients had a lower level of general health, physical functioning, social functioning, vitality and emotional status than did controls.

HIV-associated diarrhea is not as frequently reported as it was before the advent of HAART, Dr. Siddiqui told Reuters Health. "Patients are not being hospitalized as often and they are managing their condition themselves, so it is not being brought up and nobody is looking for it. And when we look back in these patients' charts, there is no mention of it. But diarrhea continues to be a major problem for these patients."

"Physicians caring for HIV-positive patients should ask them about diarrhea, maybe to help them with medical management, or to conduct a thorough work-up if indicated."

05/21/03

Reference
U Siddiqui and others. HIV-Associated Diarrhea in the Era of HAART: Still Prevalent After All These Years. Abstract S1065 (poster). Abstracts of Digestive Disease Week 2003. May 17-22, 2003. Orlando, FL.