TABLE B-2 Frequency of Diarrhea in Clinical Trials Using Protease Inhibitor-Based Therapy

Study

LPV/r

Comparator

N

%

 

N

%

KLEANa

443

11

FPV/r

436

13

GEMINIa

168

14

SQV/r

163

7

M05-730a

331

15

LPV/r

333

17

ARTEMISb

446

11

DRV/r

343

4

CASTLEb

437

12

ATV/r

441

2

NOTE:

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.

SOURCE: Buchacz et al., 2010.



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