Intestinal organisms and enteropathy in HIV related Diarrhoea and their response to Albendazole Therapy

Abstract

Treatment of HIV related diarrhoea has been a problem due to lack of effective chemotherapeutic agents against the different organisms responsible for the problem. Following the promising results of a double blind randomised placebo controlled study at the University Teaching Hospital, Lusaka , Zambia which showed that 50% of HIV positive patients with persistent diarrhoea ( diarrhoea of one month or more in duration ) and Karnofsky's score between 50 and 80 responded to 2 weeks of Albendazole therapy, a study was undertaken to establish the organisms that were eradicated by the chemotherapeutic agent. This study directly follows the previous Albendazole study which did not look at the specific organisms eradicated by the therapy. Bacterial profile of the group of patients studied was looked at and response of HIV - related enteropathy was also studied. 83 HIV positive patients with persistent diarrhoea were studied. After 2 weeks of Albendazole 800 mg twice a day, 33 ( 40% ) patients had complete response , 29 ( 35 % ) had partial response and 21 ( 25% ) did not have any response . Albendazole eradicated Microsporidium in 73 % of patients , Isospora belli in 41 % of patients and Crypotosporidium in 100 % of a small number of patients . Isospora belli was eradicated in 5 (28%) out of 18 patients by Co trimoxazole. 10 ( 55 %) of this group of patients experienced complete clinical response and 5 ( 28 % ) had partial response. 3 ( 17 % ) did not experience any response. Patients with higher CD4s showed better clinical response. Regeneration of the mucosal villi did not occur after parasites eradication.