Albendazole chemotherapy for AIDS-related diarrhoea in Zambia - clinical, parasitological and mucosal responses

Zulu, I, Veitch, A, Sianongo, S, McPhail, G, Feakins, R, Farthing, M J and Kelly, P (2002) Albendazole chemotherapy for AIDS-related diarrhoea in Zambia - clinical, parasitological and mucosal responses. Alimentary Pharmacology and Therapeutics, 16 (3). pp. 595-601. ISSN 0269-2813

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Abstract

Background:

Albendazole reduces diarrhoea in African AIDS patients, but it is unclear if the clinical response to treatment reflects pathogen eradication and/or mucosal recovery.

Methods:

Adults with HIV‐related persistent diarrhoea were treated with albendazole 800 mg twice daily for 14 days. Clearance of parasites was evaluated at 3 and 6 weeks by stool microscopy. At baseline and at 6 weeks duodenal biopsies were taken for electron microscopy (EM) and morphometry.

Results:

Ten (7%) of 153 patients had cryptosporidiosis, 54 (37%) had isosporiasis and 23 (16%) had microsporidiosis. By 3 weeks, these protozoa were cleared in 27 (46%) of 59 patients initially positive. By 6 weeks, 34 (39%) of 87 patients experienced complete clinical response, 18 (21%) partial response and 35 (40%) no response. Crypt depth increased by 15% over 6 weeks (P < 0.001), but villous height increased only in patients with complete response (median + 50 μm, interquartile range (IQR) 2–90, compared to patients with partial (+ 4 μm, IQR – 15,41) or no response (− 13 μm, IQR − 62,12; P=0.008)). Fifteen patients died: body mass index < 17.5 kg/m2 and crypt depth < 180 μm independently predicted death.

Conclusions:

Albendazole therapy reduced the burden of protozoal infection and promoted mucosal recovery in patients with a complete clinical response.

Item Type: Article
Depositing User: Adam Tickell
Date Deposited: 07 Feb 2012 15:51
Last Modified: 15 Jul 2019 11:46
URI: http://sro.sussex.ac.uk/id/eprint/36005
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