Skip to main content
NCBI home page
Elsevier - PMC COVID-19 Collection logoLink to Elsevier - PMC COVID-19 Collection
. 2018 Jul 17;8(4):857–867. doi: 10.1016/S1052-5157(18)30236-8

Evaluation of Diarrhea in HIV-Infected Patients

Douglas Simon 1,*
PMCID: PMC7129375  PMID: 9730936

Abstract

Diarrhea is a major problem for patients infected with HIV: initial studies indicated that 50% of HIV-seropositive patients developed diarrhea, but this may be an underestimate. Diarrhea has an appreciable adverse affect on the quality of life of these patients; also, they use more health care facilities and health care dollars than HIV-positive patients without diarrhea. Individuals who have homosexuality or bisexuality as their HIV risk factor are more likely to have diarrhea and to have an enteric pathogen identified as the cause of diarrhea than are patients who have heterosexuality or intravenous drug use as their risk factor.

References

  • 1.Aldras A.M., Orenstein J.M., Kotier D.P. Detection of microsporidia by indirect immunofluorescence antibody test using polyclonal and monoclonal antibodies. J Clin Microbiol. 1994;32:608–612. doi: 10.1128/jcm.32.3.608-612.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Antony M.A., Brandt L.J., Klein R.S. Infectious diarrhea in patients with AIDS. Dig Dis Sei. 1988;33:1141–1146. doi: 10.1007/BF01535791. [DOI] [PubMed] [Google Scholar]
  • 3.Bini E.J. High diagnostic yield of endoscopy in HIV-positive patients with chronic diarrhea. Gastroenterology. 1997;112:A936. [Google Scholar]
  • 4.Bini E.J., Weinshel E. Colonoscopy is superior to flexible sigmoidoscopy in HIV-positive patients with chronic diarrhea. Gastrointest Endosc. 1997;45:320. [Google Scholar]
  • 5.Blanshard C., Gazzard B.G. Natural history and prognosis of diarrhea of unknown cause in patients with acquired immunodeficiency syndrome (AIDS) Gut. 1995;36:283–286. doi: 10.1136/gut.36.2.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Connolly G., Forbes A., Gazzard B. Investigation of seemingly pathogen-negative diarrhea in patients infected with HIV 1. Gut. 1989;31:886–889. doi: 10.1136/gut.31.8.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Connolly G.M., Forbes A., Gleeson J.A. The value of barium enema and colonoscopy on patients infected with HIV. AIDS. 1990;4:687–689. doi: 10.1097/00002030-199007000-00014. [DOI] [PubMed] [Google Scholar]
  • 8.DeGirolami P.C., Exratty C.R., Desai G. Diagnosis of intestinal microsporidiosis by examination of stool and duodenal aspirates with Weber’s modified trichrome and Uvitex 2B stains. J Clin Microbiol. 1995;33:805–810. doi: 10.1128/jcm.33.4.805-810.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Dieterich D.T., Koter D.P., Busch D. Ganciclovir treatment of cytomegalovirus colitis in AIDS: A randomized, double-blind, placebo-controlled multicenter trial. J Infect Dis. 1992;167:278–283. doi: 10.1093/infdis/167.2.278. [DOI] [PubMed] [Google Scholar]
  • 10.Dieterich D., Lew E., Kotier D.P. Treatment with albendazole for intestinal disease due to Enterocytozoon bieneusi in patients with AIDS. J Infect Dis. 1994;169:178–183. doi: 10.1093/infdis/169.1.178. [DOI] [PubMed] [Google Scholar]
  • 11.Dieterich D.T., Rahmin M. Cytomegalovirus colitis in AIDS: Presentation in 44 patients and a review of the literature. J AIDS. 1991;4(suppl 1):S29–S35. [PubMed] [Google Scholar]
  • 12.Dore G.J., Marriott D.J., Hing M.C. Disseminated microsporidiosis due to Septata intestinalis in nine patients infected with human immunodeficiency virus: Response to albendazole. Clin Infect Dis. 1995;21:70–76. doi: 10.1093/clinids/21.1.70. [DOI] [PubMed] [Google Scholar]
  • 13.Greenberg P.D., Cello J.P. The diagnosis of Cryptosporidium parvum in patients with severe diarrhea and AIDS. Am J Gastroenterol. 1995;90:A1899. doi: 10.1007/BF02071413. [DOI] [PubMed] [Google Scholar]
  • 14.Greenson J., Belitsos P., Yardley J. AIDS enteropathy: Occult enteric infections and duodenal mucosal alterations in chronic diarrhea. Ann Intern Med. 1991;114:366–372. doi: 10.7326/0003-4819-114-5-366. [DOI] [PubMed] [Google Scholar]
  • 15.Horsburgh C.R. Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991;324:1332–1338. doi: 10.1056/NEJM199105093241906. [DOI] [PubMed] [Google Scholar]
  • 16.Johanson J., Sonnenberg A. Efficient management of diarrhea in the acquired immunodeficiency syndrome. Ann Intern Med. 1990;112:942–948. doi: 10.7326/0003-4819-112-12-942. [DOI] [PubMed] [Google Scholar]
  • 17.Kamradt J.M., Zwas F.R., Eisen R.N. Ileoscopy in the evaluation of diarrhea in patients with HIV infection. Gastroenterology. 1995;108:A19. [Google Scholar]
  • 18.Kearney D.J., Koch J., Cello J.P. Prospective study of endoscopic evaluation of patients with AIDS-related diarrhea. Gastroenterology. 1995;108:A20. [Google Scholar]
  • 19.Kelly P., Thillainayagam A.V., Keating J. HIV-related cryptosporidial diarrhoea: Water and electrolyte transport in human jejunum. Gastroenterology. 1994;106:A709. [Google Scholar]
  • 20.Kotier D.P., Giang T.T., Thiim M. Chronic bacterial enteropathy in patients with AIDS. J Infect Dis. 1995;171:552–558. doi: 10.1093/infdis/171.3.552. [DOI] [PubMed] [Google Scholar]
  • 21.Kotier D.P., Orenstein J.M. Prevalence of intestinal microsporidiosis in HIV-infected individuals referred for gastrointestinal evaluation. Am J Gastroenterol. 1994;89:1998–2002. [PubMed] [Google Scholar]
  • 22.Lübeck D.P., Bennett C.L., Mazonson P.D. Quality of life and health services use among HIV-infected patients with chronic diarrhea. J AIDS. 1993;6:478–484. [PubMed] [Google Scholar]
  • 23.May G.R., Gill M.J., Church D.L. Gastrointestinal symptoms in ambulatory HIV-infected patients. Dig Dis Sei. 1993;38:1388–1394. doi: 10.1007/BF01308593. [DOI] [PubMed] [Google Scholar]
  • 24.Montessori G.A., Bishoff L. Searching for parasites in stool: Once is usually enough. Can Med Assoc J. 1987;137:702. [PMC free article] [PubMed] [Google Scholar]
  • 25.Orenstein J.M., Kotier D.P. Diarrheogenic bacteral enteritis in acquired immunodeficiency syndrome. Hum Pathol. 1995;26:481–492. doi: 10.1016/0046-8177(95)90243-0. [DOI] [PubMed] [Google Scholar]
  • 26.Rabeneck L., Crane M.M., Risser J.M. Effect of transmission category and CD4 count on the occurrence of diarrhea in HIV-infected patients. Am J Gastroenterol. 1993;88:1720–1723. [PubMed] [Google Scholar]
  • 27.Rene E., Marche C., Begnier B. Intestinal infections in patients with acquired immunodeficiency syndrome. Dig Dis Sei. 1989;34:773–780. doi: 10.1007/BF01540353. [DOI] [PubMed] [Google Scholar]
  • 28.Sawitz W.G., Faust E.C. The probability of detecting intestinal protozoa by successive stool examinations. Am J Trop Med Hyg. 1942;22:131–136. [Google Scholar]
  • 29.Senay H., MacPherson D. Parasitology: Diagnostic yields of stool examination. Can Med Assoc J. 1989;140:1329–1331. [PMC free article] [PubMed] [Google Scholar]
  • 30.Simon D., Brandt L. Diarrhea in patients with AIDS. Gastroenterology. 1993;105:1238–1242. doi: 10.1016/0016-5085(93)90972-f. [DOI] [PubMed] [Google Scholar]
  • 31.Smith P.D., Lane H.C., Gill V.J. Intestinal infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med. 1988;108:328–333. doi: 10.7326/0003-4819-108-3-328. [DOI] [PubMed] [Google Scholar]
  • 32.Smith P.D., Quinn T.C., Strober W. Gastrointestinal infections in AIDS. Ann Intern Med. 1992;116:63–77. doi: 10.7326/0003-4819-116-1-63. [DOI] [PubMed] [Google Scholar]
  • 33.White A.C., Chappell C.L., Hayat C.S. Paromomycin for cryptosporidiosis in AIDS: A prospective, double blind trial. J Infect Dis. 1994;170:419–424. doi: 10.1093/infdis/170.2.419. [DOI] [PubMed] [Google Scholar]
  • 34.Wilcox C.M., Schwartz D.A., Cotsonis G. Chronic unexplained diarrhea in human immunodeficiency virus infection: Determination of the best diagnostic approach. Gastroenterology. 1996;110:30–37. doi: 10.1053/gast.1996.v110.pm8536874. [DOI] [PubMed] [Google Scholar]

Articles from Gastrointestinal Endoscopy Clinics of North America are provided here courtesy of Elsevier

RESOURCES