HIV and diarrhoea: what is new?

Beadsworth, Mike, Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 and Logan, C (2016) 'HIV and diarrhoea: what is new?'. Current Opinion in Infectious Diseases, Vol 29, Issue 5, pp. 486-494.

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Abstract

Purpose of review: The review examines the changing causes and the investigation of infectious and noninfectious diarrhoea in individuals with HIV.

Recent findings: Despite the excellent prognosis conferred by combination antiretroviral therapy, diarrhoea is still common in HIV-positive individuals and is associated with reduced quality of life and survival. There is increasing interest in the importance of Th17 and Th22 T cells in the maintenance of mucosal immunity within the gut, and in the role of the gut microbiome in gut homeostasis. Bacterial causes of HIV-associated diarrhoea continue to be important in resource-poor settings. In other settings, sexually transmitted enteric infections such as lymphogranuloma venereum and shigellosis are increasingly reported in men who have sex with men. HIV increases the risk of such infections and the presence of antimicrobial resistance. Parasitic causes of diarrhoea are more common in individuals with uncontrolled HIV and low CD4 counts. Noninfectious causes of diarrhoea include all classes of antiretroviral therapy, which is under-recognised as a cause of poor treatment adherence. Pancreatic dysfunction is remediable and the diagnostic workup of HIV-related diarrhoea should include faecal elastase measurements. New antimotility agents such as crofelemer may be useful in managing secretory diarrhoea symptoms.

Item Type:	Article
Subjects:	WA Public Health > WA 20.5 Research (General) WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WI Digestive System > WI 100 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Education
Digital Object Identifer (DOI):	https://doi.org/10.1097/QCO.0000000000000305
Depositing User:	Stacy Murtagh
Date Deposited:	15 Mar 2017 11:42
Last Modified:	09 Sep 2019 06:27
URI:	https://archive.lstmed.ac.uk/id/eprint/6234

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