Nitazoxanide for persistent diarrhoea in Zambian acquired immune deficiency syndrome patients: a randomized-controlled trial.

Abstract

BACKGROUND:

Adults with acquired immune deficiency syndrome and persistent diarrhoea in Zambia have intestinal infection, predominantly protozoa.

AIM:

To search for treatment which can be offered with minimal investigation, we carried out a double-blind, randomized-controlled trial of nitazoxanide (a drug with a range of activity against parasites and bacteria).

METHODS:

Patients with diarrhoea of 1 month duration or longer were randomized to receive nitazoxanide (1000 mg twice daily) or placebo for 2 weeks. End-points were clinical response, parasitological clearance and mortality.

RESULTS:

Two hundred and seven adults were randomized; 42 died during the study. The primary assessment of efficacy was made after 17 days. Clinical response was observed in 56 (75%) of 75 patients receiving nitazoxanide and 45 (58%) of 77 patients receiving placebo (P = 0.03). The rate of improvement was markedly higher in patients with CD4 counts under 50 cells/microL receiving nitazoxanide (P = 0.007). The benefit was largely restricted to the period when the drug was being administered. No difference was seen in parasitological clearance between the two groups. Mortality was 19% by 4 weeks of follow-up and did not differ with treatment allocation.

CONCLUSIONS:

Nitazoxanide given orally for 14 days was associated with clinical improvement in Zambian acquired immune deficiency syndrome patients with diarrhoea, especially those with very low CD4 counts.

• Authors: I Zulu, P Kelly, L Njobvu, S Sianongo, K Kaonga, V McDonald, M Farthing, R Pollok
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 21 Issue 6 Pg. 757-63 (Mar 15 2005) ISSN: 0269-2813 [Print] England
• PMID: 15771762 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antiparasitic Agents
• Nitro Compounds
• Thiazoles
• nitazoxanide

Topics

• Acquired Immunodeficiency Syndrome (complications)
• Administration, Oral
• Adult
• Antiparasitic Agents (administration & dosage)
• Bacterial Infections (drug therapy)
• CD4 Lymphocyte Count
• Chronic Disease
• Diarrhea (complications, drug therapy)
• Double-Blind Method
• Female
• Humans
• Intestinal Diseases, Parasitic (drug therapy)
• Male
• Nitro Compounds
• Thiazoles (administration & dosage)