The efficacy of calcium carbonate in the treatment of protease inhibitor-induced persistent diarrhea in HIV-infected patients.
BACKGROUND
Although some evidence exists to support the practice of using calcium carbonate to treat nelfinavir-induced diarrhea, there is a lack of data supporting the role of calcium in diarrhea induced by other protease inhibitors (PIs).


OBJECTIVE
The objective of this prospective open-label study is to evaluate the efficacy of calcium carbonate in the treatment of PI-induced persistent diarrhea in HIV-infected patients.


METHODS
Along with dietary advice, patients were asked to take oral calcium carbonate 500 mg twice daily for 2 weeks. Visual Analog Scale (VAS) and the National Cancer Institute of Canada (NCIC) scale were used to assess the severity of diarrhea. Data were analyzed using paired t tests to test for differences in VAS and NCIC scores between baseline and 14 days. Pearson correlation was used to explore the relationships between change in diarrhea and patient baseline factors.


RESULTS
At day 0, the mean VAS +/- standard deviation was 6.6 +/- 2.1 and decreased to 5.3 +/- 1.9 (p=.01) after 14 days. At day 0, the mean NCIC score was 1.9 +/- 0.8 and decreased to 1.2 +/- 0.9 (p=.005) after 14 days. No baseline patient factors predicted change in NCIC or VAS grade.


CONCLUSIONS
Calcium carbonate is associated with a reduction of diarrhea in individuals with diarrhea induced by PI.
Turner
Megan J
MJ
Pharmacy Department, The Ottawa Hospital, Ontario, Canada.
Angel
Jonathan B
JB
Woodend
Kirsten
K
Giguère
Pierre
P
D000328:Adult; D000863:Antacids / Q000627:therapeutic use*; D015704:CD4 Antigens / Q000097:blood; D002119:Calcium Carbonate / Q000627:therapeutic use*; D003967:Diarrhea / Q000139:chemically induced* / Q000188:drug therapy*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000863:Antacids; D015704:CD4 Antigens; D017320:HIV Protease Inhibitors; D002119:Calcium Carbonate