DIARRHEAL DISEASES ASSOCIATED WITH HIV INFECTION
1997; Elsevier BV; Volume: 26; Issue: 2 Linguagem: Inglês
10.1016/s0889-8553(05)70295-8
ISSN1558-1942
AutoresEdward A. Lew, Michael A. Poles, Douglas T. Dieterich,
Tópico(s)Gastrointestinal disorders and treatments
ResumoInfection with the human immunodeficiency virus (HIV) results in a chronic illness characterized by a progressive decline in cell-mediated immune function. Because of the profound immunosuppression, the gastrointestinal tract is a major target organ for opportunistic infections, neoplasia, and even local infection by HIV itself. Diarrheal disease is an extremely common complication of HIV infection and often leads to wasting and malnutrition. It has been estimated that 30% to 60% of North American and European patients with HIV develop diarrhea sometime during their clinical course, and almost 90% of patients with HIV in developing countries are similarly affected.10, 35, 51, 66, 76, 175 Although diarrhea can occur in both early and advanced HIV disease, its persistence for more than 1 month in association with unexplained weight loss of at least 10% is an acquired immunodeficiency syndrome (AIDS)–defining condition.29 Studies have shown that AIDS patients with chronic diarrhea and occult enteropathogens often have a longer duration of AIDS, a greater mean weight loss, and a significantly shorter survival than those without pathogens.75 Chronic diarrhea is an independent marker of poor prognosis in patients with AIDS.98, 119 In addition to substantial work loss and a markedly decreased quality of life, such patients also frequently have annual health costs that are 50% higher than comparable patients without diarrheal symptoms.123
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