Document 2953
 DOCN  M94A2953
 TI    Etiology, nutritional assessment and management of chronic diarrhea in
       24 HIV patients.
 DT    9412
 AU    Wanke C; Pleskow D; DeGirolami P; Federman M; New England Deaconess
       Hospital, Boston, MA.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):187 (abstract no. PB0178). Unique
       Identifier : AIDSLINE ICA10/94369622
 AB    OBJECTIVE: We studied 24 male patients (p) with HIV who had chronic
       diarrhea. METHODS: Each p had a nutritional survey, stool cultures and
       exam including cryptosporidium (cryp) and microsporidium (mic), upper
       and lower endoscopy with biopsy, electron microscopy, viral cultures and
       quantitative small bowel cultures. RESULTS: P had diarrhea for a mean
       (m) of 8.2 months, had a m CD4 count of 121, had lost a m of 12.4% of
       their ideal body weight, had a m of 4.6 stools/day, and malabsorbed a m
       of 14.4 grams of fat/day on a 100 g fat diet. 10 p had mic, 3 p had
       cryp, 1 had campylobacter, 1 had spirochetes and 9 p had no pathogen
       identified (npi). P with mic had m CD4 count of 43, m fecal fat of 23.7g
       vs. 12.5g for npi (p < 0.02), urine D-xylose of 1.5g vs. 4.6g (p <
       0.02), m vitamin B12 of 198pg vs. 620pg (p < 0.007) and m of 8 stools/d
       vs. 5 in the npi (p < 0.06). P were randomly assigned to receive one of
       two nutritionally complete liquid diets: one with medium chain
       triglycerides (MCT) Lipisorb (35% fat, 85% MCT); the other identical
       except fats were long chain triglycerides (LCT). After 12 monitored days
       of liquid diet only, the MCT group had significantly lower fecal weight
       and fat content from baseline and the LCT group (p < 0.01 for all)
       decreased stools from 4.6/d to 2.0/d. On d 12, p with mic on MCT had
       decreased fecal fat 36% from baseline vs. 15% in LCT (P < 0.01). 4/4 p
       with S. intestinalis responded completely to Albendazole therapy, while
       4/4 with E. bineusi did not. CONCLUSION: HIV patients with diarrhea and
       fat malabsorption may respond to directed therapy of their infection and
       nutritional therapy with MCT formula.
 DE    AIDS-Related Opportunistic Infections/*COMPLICATIONS/THERAPY  Chronic
       Disease  Diarrhea/*ETIOLOGY/THERAPY  Enteral Nutrition  Food, Formulated
       Human  HIV Infections/*COMPLICATIONS  Malabsorption
       Syndromes/ETIOLOGY/THERAPY  Male  *Nutrition Assessment  Nutritional
       Requirements  Triglycerides  CLINICAL TRIAL  MEETING ABSTRACT
       RANDOMIZED CONTROLLED TRIAL

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