L-glutamine supplementation improves nelfinavir-associated diarrhea in HIV-infected individuals.
OBJECTIVE
To determine whether L-glutamine decreases the severity of nelfinavir-associated diarrhea in HIV-infected individuals. Other endpoints include the effect on quality of life, muscle-wasting syndrome, CD4 counts, and viral load.


METHODS
HIV-infected patients with nelfinavir-associated diarrhea for >1 month were randomized to receive L-glutamine 30 g/day or placebo for 10 days in a prospective, double-blind, crossover study. Diarrhea was measured on a scale ranging from grade 0 (no diarrhea) to grade 4 (severe diarrhea, > 7 stools/day). Quality of life was assessed by the Medical Outcome Study (MOS) HIV questionnaire.


RESULTS
Twenty-five participants completed the study. There was a significant difference between the L-glutamine and placebo arms on the mean grade of diarrhea (0.762 vs. 1.850, p <.01) when placebo was administered first. When L-glutamine was administered first, there was a significant crossover effect (p <.02), with similar mean grades of diarrhea in the two groups. There was also a significant difference between L-glutamine and placebo in the mean change in MOS scores from baseline (1.48 vs. -2.19, p <.017). There were no significant differences between treatment groups for the other endpoints.


CONCLUSIONS
In this population of HIV-positive participants, L-glutamine 30 g/day significantly (p <.01) reduced the severity of nelfinavir-associated diarrhea and produced improved quality of life compared with placebo.
Department of Dietetics and Nutrition, College of Health and Urban Affairs, Florida International University, Miami, Florida 33172, USA. huffmanf@fiu.edu
Fatma G
FG
Huffman
Melanie E
ME
Walgren
D000284:Administration, Oral; D000328:Adult; D018592:Cross-Over Studies; D003967:Diarrhea / Q000139:chemically induced* / Q000473:pathology / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019888:Nelfinavir / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D019562:Viral Load
D017320:HIV Protease Inhibitors; D005973:Glutamine; D019888:Nelfinavir