HIV-related diarrhea is multifactorial and fat malabsorption is commonly present, independent of HAART.
OBJECTIVE
Highly active antiretroviral therapy (HAART) has significantly decreased the incidence of infectious diarrhea affecting HIV-infected patients. Still, diarrhea remains a common symptom in HIV. We sought to determine the incidence of fat malabsorption as a cause of diarrhea in HIV patients receiving non-HAART (nucleoside analog only) and HAART (protease inhibitor-containing) antiretroviral regimens.


METHODS
From June, 1995, to April, 1999, 88 HlV-infected patients underwent evaluation for diarrhea, which included endoscopy. We examined the incidence of fat malabsorption with a 24-h stool collection for fecal fat in a cohort of these patients (N = 33). Patients were divided into two groups, those receiving protease inhibitor-containing HAART and those receiving less intensive, nucleoside analog-only, non-HAART regimens.


RESULTS
Thirty of 33 patients (90.9%) had fat malabsorption. Twenty of 21 patients not receiving HAART (95.2%) had fat malabsorption with a mean of 34 +/- 38 g of stool fat and a mean stool weight of 797 +/- 454 g. Ten of 12 patients receiving HAART (83.3%) had fat malabsorption with a mean of 46 +/- 86 g of stool fat and a mean stool weight of 800 +/- 647 g. Stool weight correlated with the degree of fat malabsorption (R = 0.77).


CONCLUSIONS
Fat malabsorption represents a commonly undiagnosed entity in HIV-infected patients with diarrhea, whether or not they are receiving HAART therapy. Fecal fat determination should be considered a routine part of the diagnostic workup of HIV-infected patients experiencing diarrhea.
Poles
M A
MA
UCLA Center for HIV and Digestive Diseases, UCLA School of Medicine, Los Angeles, California 90095, USA.
Fuerst
M
M
McGowan
I
I
Elliott
J
J
Rezaei
A
A
Mark
D
D
Taing
P
P
Anton
P A
PA
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000378:metabolism* / Q000382:microbiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D003967:Diarrhea / Q000150:complications / Q000209:etiology* / Q000378:metabolism; D005223:Fats / Q000378:metabolism*; D005243:Feces / Q000737:chemistry; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007408:Intestinal Absorption; D008297:Male
D005223:Fats