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9th Annual Conference Of The British HIV Association [BHIVA]24 – 26 April 2003, University of Manchester
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[AUTHOR(S):] DA Price, KMB Ajdukiewicz, B Peaston, ELC Ong, MH Snow and ML Schmid
Newcastle General Hospital, Newcastle-upon-Tyne, UK
BHIVA Conf 2003 Apr 24-26;9:O23
BACKGROUND: HIV+ patients on highly active antiretroviral therapy (HAART) may develop chronic diarrhoea. Microbiological, histological and endoscopic investigations are frequently negative and patients receive symptomatic treatment for presumed antiretroviral side effects. Low faecal elastase (<100 µg/g) is a marker of exocrine pancreatic insufficiency (a cause of chronic diarrhoea).
METHODS: Retrospective case-note analysis of HIV+ patients on HAART with chronic diarrhoea and measurement of weight and faecal elastase.
RESULTS: 7/22 HIV+ patients whose faecal elastase was measured had <100 µg/g, indicative of severe exocrine pancreatic insufficiency. All seven had negative stool cultures and microscopy. All chronic diarrhoea patients with low faecal elastase had lost weight (2–10 kg). Patients with normal faecal elastase had not lost weight. 4/7 patients with low faecal elastase had symptoms of fat malabsorption compared with none in the normal faecal elastase group. 5/7 of the patients with diarrhoea were on a protease inhibitor, 4/7 on didanosine and 5/7 on stavudine. 1/7 also had giardiasis. 6/7 patients with low faecal elastase levels were started on pancreatic enzyme supplementation with marked improvement of symptoms. 1/7 died of endstage HIV disease.
CONCLUSIONS: HIV+ patients with chronic diarrhoea on HAART should have their pancreatic function assessed, particularly if associated with weight loss or symptoms of fat malabsorption and, if deficient, should be treated with pancreatic enzyme supplements.
PRESENTING AUTHOR: DA Price
030424
O23
Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD