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Review| Volume 3, ISSUE 3, P164-167, March 1999

Epidemiology and management of diarrheal disease in HIV infected patients

Open ArchiveDOI:https://doi.org/10.1016/S1201-9712(99)90040-1
Epidemiology and management of diarrheal disease in HIV infected patients
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      Abstract

      Diarrhea is the most common gastrointestinal symptom in human immunodeficiency virus (HIS infection. It affects up to 90% of patients, becoming more frequent and severe as the immune system deteriorates. It often is associated with significant morbidity and mortality particularly in the developing countries. Gastrointestinal infections, some of which are attributable to inadequate sanitation and poor hygiene are the predominant cause of diarrhea, although multiple medications, including traditional herbs, also may be causes. The basic principles of management include detection of treatable causes, relief of symptoms, prevention of malnutrition, and psychosocial support. In up to 60% of cases, no cause can be identified, partly because of inadequate investigative facilities. Symptomatic treatment is the mainstay of management particularly when no cause can be identified. Unfortunately this can be extremely difficult when the patient is severely immune-suppressed. There is poor response to motility control drugs, such as loperamide, and others, such as octrectlde, are too expensive. Fluid replacement should be started early to prevent excessive dehydration. This should be combined with nutritional support to prevent malnutrition. Psychosocial support, including counselling, for both the patient and the caring relatives, is required to alleviate anxiety, particularly when the diarrhea becomes intractable.

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      References

        • Serwadda D.
        • Mugerwa R.
        • Sewankambo N.
        • et al.
        Slim disease; a new disease in Uganda and its association with HTLV III infection.
        Lancet. 1985; 2: 849-852
        • Mhiri C.
        • Bélec L.
        • Di Costanzo B.
        • Georges A.
        • Gherardi R.
        The slim disease in African patients with AIDS.
        Trans R Soc Trop Med Hyg. 1992; 86: 303-306
        • Colebunders R.
        • Francis H.
        • Mann J.M.
        • et al.
        Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire.
        Am J Gastroenterol. 1987; 82: 859-864
        • O'Keefe E.A.
        • Wood R.
        AIDS in Africa.
        Scand J Gastroenterol Suppl. 1996; 220: 147-152
        • Kelly P.
        • Baboo K.S.
        • Wolff M.
        • Ngwenya B.
        • Luo N.
        • Farthing M.J.
        The prevalence and etiology of persistent diarrhea in adults in urban Zambia.
        Acta Trop. 1996; 61: 183-190
        • Thea D.M.
        • Glass R.
        • Grohmann G.S.
        • et al.
        Prevalence of enteric viruses among hospital patients with AIDS in Kinshasa, Zaire.
        Trans R Soc Trop Med Hyg. 1993; 87: 263-266
        • Colebunders R.L.
        • Latif A.S.
        Natural history and clinical presentation of HIV-1 infection in adults.
        AIDS. 1991; 5 (Suppl): S103-S112
        • Mugerwa R.D.
        • Marum L.H.
        • Serwadda D.
        Human immunodeficiency virus and AIDS in Uganda.
        East Afr Med J. 1996; 73: 20-25
        • Sewankambo N.K.
        • Mugerwa R.D.
        • Goodgame R.
        • et al.
        Enteropathic AIDS in Uganda. An endoscopic, histological, and microbiological study.
        AIDS. 1987; 1: 9-13
        • Colebunders R.
        • Lusakumunu K.
        • Nelson A.M.
        • et al.
        Persistent diarrhea in Zairian AIDS patients: an endoscopic and histological study.
        Gut. 1988; 29: 1687-1691
        • Conlon C.P.
        • Pinching A.J.
        • Perera C.U.
        • Moody A.
        • Luo N.P.
        • Lucas S.B.
        HIV-related enteropathy in Lusaka, Zambia: a clinical, microbiological, and histological study.
        Am J Trop Med Hyg. 1990; 42: 83-88
        • Lucas S.B.
        • Papadaki L.
        • Conlon C.
        • Sewankambo N.
        • Goodgame R
        • Serwadda D.
        Diagnosis of intestinal microsporidiosis in patients with AIDS.
        J Clin Pathol. 1989; 42: 885-887
        • Katabira E.
        • Goodgame R.
        AIDS care: diagnostic and treatment strategies for health workers.
        AIDS Control Programme, Ministry of Health, Entebbe, Uganda1989
        • Katabira E.T.
        • Wabitsch R.K.
        Management issues for patients with HIV infection in Africa.
        AIDS. 1991; 5 (Suppl): S149-S155

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      DOI: https://doi.org/10.1016/S1201-9712(99)90040-1

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