Diarrhea and Reduced Levels of Antiretroviral Drugs: Improvement with Glutamine or Alanyl-glutamine

The effects of therapy with glutamine and alanyl-glutamine on diarrhea and antiretroviral drug levels in patients with AIDS were examined in a randomized, double-blinded, placebo-controlled study in northeast Brazil.

Patients with AIDS and with diarrhea and/or wasting were randomized into 4 groups to determine the efficacy of glutamine or high- or low-dose alanyl-glutamine given for 7 days, compared with isonitrogenous glycine given to control subjects.

All patients in whom baseline antiretroviral drug levels were determined had low levels 2 hours after dosing.

Gastrointestinal symptom scores improved with receipt of high-dose alanyl-glutamine (P<.05) or glutamine (P<.01).

Antiretroviral drug levels increased in patients given alanyl-glutamine (P=.02) or glutamine (P=.03) by 113% (P=.02) and 14% (P=.01), respectively.

Antiretroviral drug resistance mutations were common in all groups.

The authors conclude, “The dose-related efficacy of alanyl-glutamine and glutamine in treating diarrhea and in increasing antiretroviral drug levels shows that these supplements may help to improve therapy for patients with AIDS who have diarrhea and/or wasting in developing, tropical areas.”

Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA. rlg9a@virginia.edu

07/07/04