{"id":4756,"date":"2001-09-01T14:01:55","date_gmt":"2001-09-01T13:01:55","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=4756"},"modified":"2014-06-11T17:05:22","modified_gmt":"2014-06-11T17:05:22","slug":"fat-malabsorption-common-cause-of-diarrhoea-in-hiv-infected-patients","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/4756","title":{"rendered":"Fat malabsorption common cause of diarrhoea in HIV-positive patients"},"content":{"rendered":"<p><strong>Fat malabsorption is a commonly undiagnosed cause of diarrhoea in HIV-positive\u00a0patients, whether or not they have received highly active antiretroviral therapy (HAART), according to a report published in the June issue of the American Journal of Gastroenterology.<\/strong><\/p>\n<p>Dr. Michael A. Poles and colleagues from the University of California at Los Angeles assessed the incidence of fat malabsorption in 33 HIV-positive\u00a0patients who underwent evaluation for diarrhoea between June 1995 and April 1999. Twelve of the patients were receiving HAART and 21 were receiving nucleoside analogues only.<\/p>\n<p>All but three subjects had fat malabsorption, including 10 patients in the HAART group and 20 patients in the non-HAART group, the authors report. Mean stool fat weight was lower in the non-HAART group, but both groups had similar mean stool weights.<\/p>\n<p>\u201cThe assumption has been that because HAART reduces the incidence of opportunistic infections there would be a subsequent decrease in diarrhoea,\u201d Dr. Poles told Reuters Health. \u201cUnfortunately that doesn\u2019t seem to be the case, [because] HAART-treated patients still experience a significant rate of diarrhoea,\u201d he said. \u201cFat malabsorption is probably a significant cause of diarrhoea in these patients, certainly worthy of an attempt at diagnosis and treatment.\u201d<\/p>\n<p>Dr. Poles noted that \u201cin general, when we think of a cause for fat malabsorption we usually think of pancreatic disease.\u201d However, \u201cthe patients in the current study did not seem to have any real evidence of pancreatic disease,\u201d he said.<\/p>\n<p>\u201cThe cause may be more at the molecular level,\u201d Dr. Poles postulated. \u201cNucleoside analogues, and, to a lesser extent, protease inhibitors may have some effect on the pancreas. Findings from a post-mortem study of HIV-positive\u00a0patients showed that a fairly large proportion do have some evidence of subclinical disease.\u201d<\/p>\n<p>Dr. Poles believes that physicians who see HIV-positive\u00a0patients with diarrhoea need to first consider fat malabsorption in the differential diagnosis. \u201cAt our institution, we do a 24-hour faecal fat assay after a fat challenge,\u201d he said. \u201cOnce we\u2019ve found fat malabsorption, we treat the patient with pancreatic enzyme replacement.\u201d<\/p>\n<p>Reference:<\/p>\n<p>Am J Gastroenterol 2001;96:1831-1837.<\/p>\n<p>Source: Reuters Health<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fat malabsorption is a commonly undiagnosed cause of diarrhoea in HIV-positive\u00a0patients, whether or not they have received highly active antiretroviral therapy (HAART), according to a report published in the June issue of the American Journal of Gastroenterology. Dr. Michael A. &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-4756","post","type-post","status-publish","format-standard","hentry","category-side-effects"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4756","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=4756"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4756\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=4756"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=4756"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=4756"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}