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. SUMMARY:Clinicians looking after patients with HIV should ask about diarrhoeal symptoms, which are under-reported and may have a remediable infectious or noninfectious cause.
journal_name
Curr Opin Infect Disjournal_title
Current opinion in infectious diseasesauthors
Logan C,Beadsworth MB,Beeching NJdoi
10.1097/QCO.0000000000000305subject
Has Abstractpub_date
2016-10-01 00:00:00pages
486-94issue
5eissn
0951-7375issn
1473-6527journal_volume
29pub_type
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journal_title:Current opinion in infectious diseases
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journal_title:Current opinion in infectious diseases
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journal_title:Current opinion in infectious diseases
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更新日期:2012-12-01 00:00:00
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更新日期:2021-01-05 00:00:00
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journal_title:Current opinion in infectious diseases
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更新日期:1998-04-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-04-01 00:00:00