HIV/AIDS

H/A: Diarrhea/Malabsorption (2009)

• Intervention
  What is the evidence regarding dietary treatment of diarrhea/malabsorption in people with HIV infection?

  • Conclusion

    Seven studies were reviewed to evaluate dietary treatment of diarrhea/malabsorption in people with HIV infection. Many of these studies did not provide information on medications.  Two studies regarding fat malabsorption reported that consumption of medium chain triglycerides resulted in fewer stools, decreased stool fat and weight and increased fat absorption. Two studies regarding vitamin A and beta-carotene supplementation reported decreased gut permeability and risk of severe watery diarrhea. Further research regarding amino acid-based elemental diets, probiotics, pancreatic enzyme therapy, calcium carbonate, glutamine and the BRAT diet in people with HIV/AIDS is warranted, as well as the effect of medications.

     

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Dietary treatment of diarrhea/malabsorption in people with HIV infection
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Allen SJ, Okoko B, Martinez E, Gregorio G, Dans LF. Probiotics for treating infectious diarrhoea. Cochrane Database Syst Rev. 2004; (2): CD003048. 
      • Amadi B, Mwiya M, Chomba E, Thomson M, Chintu C, Kelly P, Walker-Smith J. Improved nutritional recovery on an elemental diet in Zambian children with persistent diarrhea and malnutrition. J Trop Pediatr. 2005; 51(1): 5-10.
      • Carroccio A, Guarino A, Zuin G, Verghi F, Berni Canani R, Fontana M, Bruzzese E, Montalto G, Notarbartolo A. Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV-infected patients. Aliment Pharmacol Ther. 2001; 15: 1619-1625.
      • Craig CB, Darnell BE, Weinsier RL, Saag MS, Epps L, Mullins L, Lapidus WI, Ennis DM, Akrabawi SS, Cornwell PE, Sauberlich HE. Decreased fat and nitrogen losses in patients with AIDS receiving medium-chain-triglyceride-enriched formula vs those receiving long-chain-triglyceride-containing formula. J Am Diet Assoc. 1997; 97: 605-611.
      • Fawzi WW, Mbise R, Spiegelman D, Fataki M, Hertzmark E, Ndossi G. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. J Pediatr. 2000; 137(5): 660-667.
      • Filteau SM, Rollins NC, Coutsoudis A, Sullivan KR, Willumsen JF, Tomkins AM. The effect of antenatal vitamin A and beta-carotene supplementation on gut integrity of infants of HIV-infected South African women. J Pediatr Gastroenterol Nutr. 2001; 32(4): 464-470.
      • Turner MJ, Angel JB, Woodend AK, Giguere P. The efficacy of calcium carbonate in the treatment of protease inhibitor-induced persistent diarrhea in HIV-infected patients. HIV Clin Trials. 2004; 5(1): 19-24. 
      • Wanke CA, Pleskow D, Degirolami PC, Lambl BB, Merkel K, Akrabawi S. A medium chain triglyceride-based diet in patients with HIV and chronic diarrhea reduces diarrhea and malabsorption: A prospective, controlled trial. Nutrition. 1996; 12(11-12): 766-771.
  • Search Plan and Results: Dietary Treatment of Diarrhea/Malabsorption 2008