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HIV and Disability: Updating the Social Security Listings
TABLE B-2 Frequency of Diarrhea in Clinical Trials Using Protease Inhibitor-Based Therapy
aKLEAN, GEMINI, and M05-730 represent 48-week data;
bARTEMIS and CASTLE represent 96-week data.
SOURCES: Eron et al., 2006; Gathe et al., 2009; Mills et al., 2009; Molina, 2008.
seminated Mycobacterium avium, and disseminated cytomegalovirus infection. The rates of these conditions are shown in Table B-3.
As discussed in Chapter 5, diarrhea in people infected with HIV can often be treated with antibiotics, but may require combination antiretroviral therapy. These therapies are generally quite effective; some nonspecific therapies such as loperamide also have been successful.
The literature is sparse about the current association between diarrhea and HIV-associated wasting syndrome. HIV-associated wasting has been defined as the following: unintentional weight loss of greater than 10 percent, body mass index (BMI) decreasing to less than 20, and a rapid weight loss of greater than 5 percent in 6 months (Mangili et al., 2006). In 466 participants with HIV in the Nutrition for Healthy Living Cohort, 18 percent lost greater than 10 percent of their weight, 8 percent had a BMI less than 20, and 21 percent lost greater than 5 percent in 6 months. Every 1 percent increase in weight loss correlated to an 11 percent increase risk of death. Weight loss was attributed to
TABLE B-3 AIDS-Defining Conditions That Often Present With Severe Diarrhea in the HOPS Cohort of 8,070 Participants
Condition
Rate (per 1,000 patient years)
Pre-HAART 1994–1997
HAART 2003–2007
Cryptosporidiosis
7.3
0.8
Mycobacterium avium
26.9
2.5
Cytomegalovirus
33.0
1.8
NOTE: HAART = highly active antiretroviral therapy.