Etiology and pharmacologic management of noninfectious diarrhea in HIV-infected individuals in the highly active antiretroviral therapy era.

Abstract

Diarrhea remains a common problem for patients with human immunodeficiency virus (HIV) infection despite highly active antiretroviral therapies (HAART) and can negatively affect patient quality of life and lead to discontinuation or switching of HAART regimens. In the era of HAART, diarrhea from opportunistic infections is uncommon, and HIV-associated diarrhea often has noninfectious causes, including HAART-related adverse events and HIV enteropathy. Diarrhea associated with HAART is typically caused by protease inhibitors (eg, ritonavir), which may damage the intestinal epithelial barrier (leaky-flux diarrhea) and/or alter chloride ion secretion (secretory diarrhea). HIV enteropathy may result from direct effects of HIV on gastrointestinal tract cells and on the gastrointestinal immune system and gut-associated lymphoid tissue, which may be active sites of HIV infection and ongoing inflammation and mucosal damage. New therapies targeting the pathogenic mechanisms of noninfectious diarrheas are needed.

• Authors: Rodger D MacArthur, Herbert L DuPont
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 55 Issue 6 Pg. 860-7 (Sep 2012) ISSN: 1537-6591 [Electronic] United States
• PMID: 22700829 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• HIV Protease Inhibitors

Topics

• Antiretroviral Therapy, Highly Active (adverse effects, methods)
• Diarrhea (chemically induced, therapy)
• HIV (pathogenicity)
• HIV Infections (complications, drug therapy, virology)
• HIV Protease Inhibitors (administration & dosage, adverse effects)
• Humans