Premium
Albendazole chemotherapy for AIDS‐related diarrhoea in Zambia—clinical, parasitological and mucosal responses
Author(s) -
Zulu I.,
Veitch A.,
Siago S.,
McPhail G.,
Feakins R.,
Farthing M. J. G.,
Kelly P.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2002.01182.x
Subject(s) - albendazole , medicine , interquartile range , gastroenterology , chemotherapy , microsporidiosis , anthelmintic , immunology , surgery , veterinary medicine , protozoal disease , malaria
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/m 2 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.