Boncy M, Laroche AC, Liautaud B, Mathurin JR, Pape JW, Pamphile M, PĆ©an V, St-Amand MM, Thomas F, Arnoux E, Elie R, GuĆ©rin JM, Laroche AC, Malebranche R, Pierre G, 1983. Acquired immunodeficiency in Haitians. N Engl J Med 308: 1419ā1420.
Carcamo C, Hooton T, Wener MH, Weiss NS, Gilman R, Arevalo J, Carrasco J, Seas C, Caballero M, Holmes KK, 2005. Etiologies and manifestations of persistent diarrhea in adults with HIV-1 infection: a case-control study in Lima, Peru. J Infect Dis 191: 11ā19.
Chakraborty N, Mukherjee A, Santra S, Sarkar RN, Banerjee D, Guha SK, Chakraboty S, Bhattacharyya SK, 2008. Current trends of opportunistic infections among HIV-seropositive patients from Eastern India. Jpn J Infect Dis 61: 49ā53.
Akolo C, Ukoli CO, Ladep GN, Idoko JA, 2008. The clinical features of HIV/AIDS at presentation at the Jos University Teaching Hospital. Niger J Med 17: 83ā87.
Mwachari CW, Meier AS, Muyodi J, Gatei W, Waiyaki P, Cohen CR, 2003. Chronic diarrhea in HIV-1-infected adults in Nairobi, Kenya: evaluation of risk factors and the WHO treatment algorithm. AIDS 17: 2124ā2126.
Dillingham RA, Pinkerton R, Leger P, Severe P, Guerrant RL, Pape JW, Fitzgerald DW, 2009. High early mortality in patients with chronic acquired immunodeficiency syndrome diarrhea initiating antiretroviral therapy in Haiti: a case-control study. Am J Trop Med Hyg 80: 1060ā1064.
Weber R, Ledergerber B, Zbinden R, Altwegg M, Pfyffer GE, Spycher MA, Briner J, Kaiser L, Opravil M, Meyenberger C, Flepp M, 1999. Enteric infections and diarrhea in human immunodeficiency virus-infected persons: prospective community-based cohort study. Swiss HIV Cohort Study. Arch Intern Med 159: 1473ā1480.
Gurumurthy P, Ramachandran G, Hemanth Kumar AK, Rajasekaran S, Padmapriyadarsini C, Swaminathan S, Venkatesan P, Sekar L, Kkumar S, Krishnarnjasekhar OR, Paramesh P, 2004. Malabsorption of rifampin and isoniazid in HIV-infected patients with and without tuberculosis. Clin Infect Dis 38: 280ā283.
Mouly S, Aymard G, Tillement JP, Caulin C, Bergmann JF, Urien S, 2001. Increased oral ganciclovir bioavailability in HIV-infected patients with chronic diarrhea and wasting syndromeāa population pharmacokinetic study. Br J Clin Pharmacol 51: 557ā565.
Brantley RK, Williams KR, Silva TM, Sistrom M, Thielman NM, Ward H, Lima AA, Guerrant RL, 2003. AIDS-associated diarrhea and wasting in Northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum. Braz J Infect Dis 7: 16ā22.
Bushen OY, Davenport JA, Lima AB, Piscitelli SC, Uzgiris AJ, Silva TM, Leife R, Kosek M, Dillingham RA, Girao A, Lima AA, Guerrant RL, 2004. Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil. Clin Infect Dis 38: 1764ā1770.
Macnab KA, Gill MJ, Sutherland LR, Murphy A, Brant R, 1996. Zidovudine absorption and small intestinal function in HIV seropositive patients. J Antimicrob Chemother 37: 825ā829.
Sahai J, Gallicano K, Swick L, Tailor S, Garber G, Seguin I, Oliveras L, Walker S, Rachlis A, Cameron DW, 1997. Reduced plasma concentrations of antituberculosis drugs in patients with HIV infection. Ann Intern Med 127: 289ā293.
Leth FV, Kappelhoff BS, Johnson D, Losso MH, Boron-Kaczmarska A, Saag MS, Livrozet JM, Hall DB, Leith J, Huitema AD, Wit FW, Beijnen JH, Lange JM, 2NN Study Group, 2006. Pharmacokinetic parameters of nevirapine and efavirenz in relation to antiretroviral efficacy. AIDS Res Hum Retroviruses 22: 232ā239.
Fletcher CV, Kawle SP, Kakuda TN, Anderson PL, Weller D, Bushman LR, Brundage RC, Remmel RP, 2000. Zidovudine triphosphate and lamivudine triphosphate concentration-response relationships in HIV-infected persons. AIDS 14: 2137ā2144.
Fletcher CV, Anderson PL, Kakuda TN, Schacker TW, Henry K, Gross CR, Brundage RC, 2002. Concentration-controlled compared with conventional antiretroviral therapy for HIV infection. AIDS 16: 551ā560.
Marzolini C, Telenti A, Decosterd LA, Greub G, Biollaz J, Buclin T, 2001. Efavirenz plasma levels can predict treatment failure and central nervous system side effects in HIV-1-infected patients. AIDS 15: 71ā75.
World Health Organization, 2006. Antiretroviral therapy for HIV infection in adults and adolescents in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva, Switzerland: WHO.
Severe P, Leger P, Charles M, Noel F, Bonhomme G, Bois G, George E, Kenel-Pierre S, Wright PF, Galick R, Johnson WD Jr, Pape JW, Fitzgerald DW, 2005. Antiretroviral therapy in a thousand patients with AIDS in Haiti. N Engl J Med 353: 2325ā2334.
Leger P, Charles M, Severe P, Riviere C, Pape JW, Fitzgerald DW, 2009. 5-year survival of patients with AIDS receiving antiretroviral therapy in Haiti. N Engl J Med 361: 828ā829.
Parr JB, Sevilleja JE, Samie A, Alcantara C, Stroup SE, Kohli A, Fayer R, Lima AA, Houpt ER, Guerrant RL, 2007. Detection and quantification of Cryptosporidium in HCT-8 cells and human fecal specimens using real-time polymerase chain reaction. Am J Trop Med Hyg 76: 938ā942.
Samie A, Obi CL, Barrett LJ, Powell SM, Guerrant RL, 2007. Prevalence of Campylobacter species, Helicobacter pylori and Arcobacter species in stool samples from the Venda region, Limpopo, South Africa: studies using molecular diagnostic methods. J Infect 54: 558ā566.
Samie A, Obi CL, Tzipori S, Weiss LM, Guerrant RL, 2007. Microsporidiosis in South Africa: PCR detection in stool samples of HIV-positive and HIV-negative individuals and school children in Vhembe district, Limpopo Province. Trans R Soc Trop Med Hyg 101: 547ā554.
Samie A, Obi CL, Franasiak J, Rchbald-Pannone L, Bessong PO, Cantara-Warren C, Guerrant RL, 2008. PCR detection of Clostridium difficile triose phosphate isomerase (tpi), toxin A (tcdA), toxin B (tcdB), binary toxin (cdtA, cdtB), and tcdC genes in Vhembe District, South Africa. Am J Trop Med Hyg 78: 577ā585.
Sturbaum GD, Reed C, Hoover PJ, Jost BH, Marshall MM, Sterling CR, 2001. Species-specific, nested PCR-restriction fragment length polymorphism detection of single Cryptosporidium parvum oocysts. Appl Environ Microbiol 67: 2665ā2668.
Samie A, Obi CL, Dillingham R, Pinkerton RC, Guerrant RL, 2007. Enteroaggregative Escherichia coli in Venda, South Africa: distribution of virulence-related genes by multiplex polymerase chain reaction in stool samples of human immunodeficiency virus (HIV)-positive and HIV-negative individuals and primary school children. Am J Trop Med Hyg 77: 142ā150.
Rezk NL, Tidwell RR, Kashuba AD, 2003. Simultaneous determination of six HIV nucleoside analogue reverse transcriptase inhibitors and nevirapine by liquid chromatography with ultraviolet absorbance detection. J Chromatogr B Analyt Technol Biomed Life Sci 791: 137ā147.
Rezk NL, Crutchley RD, Yeh RF, Kashuba AD, 2006. Full validation of an analytical method for the HIV-protease inhibitor atazanavir in combination with 8 other antiretroviral agents and its applicability to therapeutic drug monitoring. Ther Drug Monit 28: 517ā525.
Leger P, Dillingham R, Beauharnais CA, Kashuba AD, Rezk NL, Fitzgerald DW, Pape JW, Haas DW, 2009. CYP2B6 variants and plasma efavirenz concentrations during antiretroviral therapy in Port-au-Prince, Haiti. J Infect Dis 200: 955ā964.
Durrer P, Zbinden R, Fleisch F, Altwegg M, Ledergerber B, Karch H, Weber R, 2000. Intestinal infection due to enteroaggregative Escherichia coli among human immunodeficiency virus-infected persons. J Infect Dis 182: 1540ā1544.
Wanke CA, Mayer H, Weber R, Zbinden R, Watson DA, Acheson D, 1998. Enteroaggregative Escherichia coli as a potential cause of diarrheal disease in adults infected with human immunodeficiency virus. J Infect Dis 178: 185ā190.
Yamamoto T, Echeverria P, Yokota T, 1992. Drug resistance and adherence to human intestines of enteroaggregative Escherichia coli. J Infect Dis 165: 744ā749.
Gassama A, AĆÆdara-Kane A, Chainier D, Denis F, Ploy MC, 2004. Integron-associated antibiotic resistance in enteroaggregative and enteroinvasive Escherichia coli. Microb Drug Resist 10: 27ā30.
Steiner TS, Lima AA, Nataro JP, Guerrant RL, 1998. Enteroaggregative Escherichia coli produce intestinal inflammation and growth impairment and cause interleukin-8 release from intestinal epithelial cells. J Infect Dis 177: 88ā96.
Roche JK, Cabel A, Sevilleja J, Nataro J, Guerrant RL, 2010. Enteroaggregative Escherichia coli (EAEC) impairs growth while malnutrition worsens EAEC infection: a novel murine model of the infection malnutrition cycle. J Infect Dis 202: 506ā514.
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Diarrhea in patients with acquired immunodeficiency syndrome (AIDS) may cause malabsorption of medications and failure of antiretroviral therapy (ART). We prospectively evaluated human immunodeficiency virus-1 (HIV-1)-infected patients with and without chronic diarrhea initiating ART in Haiti. We report mean plasma antiretroviral concentrations at 2 and 4 weeks. We measured plasma HIV-1 RNA levels at four points. Fifty-two HIV-1-infected patients (26 matched pairs) were enrolled. No differences in antiretroviral concentrations were detected. At week 24, 18/25 (72%) cases and 16/24 (68%) controls had undetectable plasma HIV-1 RNA levels (P = 0.69). Patients with plasma HIV-1 RNA levels > 50 copies/mL at week 24 had lower early efavirenz concentrations than patients with undetectable HIV-1 RNA (2,621 ng/mL versus 5,278 ng/mL; P = 0.02). Diarrhea at ART initiation does not influence plasma concentrations of the medications evaluated. Virologic outcome at Week 24 does correlate with efavirenz concentrations early in therapy but not with the presence of chronic diarrhea.
Financial support: The study was supported by NIH grants AI077339, AI064021, AI007046, AI50410, TW006901, and TW00018.
Authors' addresses: Rebecca Dillingham and Richard Guerrant, University of Virginia, Center for Global Health, Charlottesville, VA, E-mails: rd8v@virginia.edu and rlg9a@virginia.edu. Paul Leger, Carole-Anne Beauharnais, Etna Eyma, and Jean Pape, GHESKIO, Port au Prince, Haiti, E-mails: Paul.d.leger@vanderbilt.edu, caroleanne26@hotmail.com, etna_e@yahoo.fr.com, and jwpape@gheskio.org. Erica Miller, Kathryn Dupnik, and Daniel Fitzgerald, Weill Medical College of Cornell University, New York, NY, E-mails: Erica.olson.miller@gmail.com, kad9040@nyp.org, and dfitzgerald@gheskio.org. Angela Kashuba and Steven Jennings, University of North Carolina, Center for AIDS Research, Chapel Hill, NC, E-mails: akashuba@unc.edu and sjenning@email.unc.edu. Amidou Samie, University of Venda, Department of Microbiology, Thohoyandou, South Africa, E-mail: samieamidou@yahoo.com.
Boncy M, Laroche AC, Liautaud B, Mathurin JR, Pape JW, Pamphile M, PĆ©an V, St-Amand MM, Thomas F, Arnoux E, Elie R, GuĆ©rin JM, Laroche AC, Malebranche R, Pierre G, 1983. Acquired immunodeficiency in Haitians. N Engl J Med 308: 1419ā1420.
Carcamo C, Hooton T, Wener MH, Weiss NS, Gilman R, Arevalo J, Carrasco J, Seas C, Caballero M, Holmes KK, 2005. Etiologies and manifestations of persistent diarrhea in adults with HIV-1 infection: a case-control study in Lima, Peru. J Infect Dis 191: 11ā19.
Chakraborty N, Mukherjee A, Santra S, Sarkar RN, Banerjee D, Guha SK, Chakraboty S, Bhattacharyya SK, 2008. Current trends of opportunistic infections among HIV-seropositive patients from Eastern India. Jpn J Infect Dis 61: 49ā53.
Akolo C, Ukoli CO, Ladep GN, Idoko JA, 2008. The clinical features of HIV/AIDS at presentation at the Jos University Teaching Hospital. Niger J Med 17: 83ā87.
Mwachari CW, Meier AS, Muyodi J, Gatei W, Waiyaki P, Cohen CR, 2003. Chronic diarrhea in HIV-1-infected adults in Nairobi, Kenya: evaluation of risk factors and the WHO treatment algorithm. AIDS 17: 2124ā2126.
Dillingham RA, Pinkerton R, Leger P, Severe P, Guerrant RL, Pape JW, Fitzgerald DW, 2009. High early mortality in patients with chronic acquired immunodeficiency syndrome diarrhea initiating antiretroviral therapy in Haiti: a case-control study. Am J Trop Med Hyg 80: 1060ā1064.
Weber R, Ledergerber B, Zbinden R, Altwegg M, Pfyffer GE, Spycher MA, Briner J, Kaiser L, Opravil M, Meyenberger C, Flepp M, 1999. Enteric infections and diarrhea in human immunodeficiency virus-infected persons: prospective community-based cohort study. Swiss HIV Cohort Study. Arch Intern Med 159: 1473ā1480.
Gurumurthy P, Ramachandran G, Hemanth Kumar AK, Rajasekaran S, Padmapriyadarsini C, Swaminathan S, Venkatesan P, Sekar L, Kkumar S, Krishnarnjasekhar OR, Paramesh P, 2004. Malabsorption of rifampin and isoniazid in HIV-infected patients with and without tuberculosis. Clin Infect Dis 38: 280ā283.
Mouly S, Aymard G, Tillement JP, Caulin C, Bergmann JF, Urien S, 2001. Increased oral ganciclovir bioavailability in HIV-infected patients with chronic diarrhea and wasting syndromeāa population pharmacokinetic study. Br J Clin Pharmacol 51: 557ā565.
Brantley RK, Williams KR, Silva TM, Sistrom M, Thielman NM, Ward H, Lima AA, Guerrant RL, 2003. AIDS-associated diarrhea and wasting in Northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum. Braz J Infect Dis 7: 16ā22.
Bushen OY, Davenport JA, Lima AB, Piscitelli SC, Uzgiris AJ, Silva TM, Leife R, Kosek M, Dillingham RA, Girao A, Lima AA, Guerrant RL, 2004. Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil. Clin Infect Dis 38: 1764ā1770.
Macnab KA, Gill MJ, Sutherland LR, Murphy A, Brant R, 1996. Zidovudine absorption and small intestinal function in HIV seropositive patients. J Antimicrob Chemother 37: 825ā829.
Sahai J, Gallicano K, Swick L, Tailor S, Garber G, Seguin I, Oliveras L, Walker S, Rachlis A, Cameron DW, 1997. Reduced plasma concentrations of antituberculosis drugs in patients with HIV infection. Ann Intern Med 127: 289ā293.
Leth FV, Kappelhoff BS, Johnson D, Losso MH, Boron-Kaczmarska A, Saag MS, Livrozet JM, Hall DB, Leith J, Huitema AD, Wit FW, Beijnen JH, Lange JM, 2NN Study Group, 2006. Pharmacokinetic parameters of nevirapine and efavirenz in relation to antiretroviral efficacy. AIDS Res Hum Retroviruses 22: 232ā239.
Fletcher CV, Kawle SP, Kakuda TN, Anderson PL, Weller D, Bushman LR, Brundage RC, Remmel RP, 2000. Zidovudine triphosphate and lamivudine triphosphate concentration-response relationships in HIV-infected persons. AIDS 14: 2137ā2144.
Fletcher CV, Anderson PL, Kakuda TN, Schacker TW, Henry K, Gross CR, Brundage RC, 2002. Concentration-controlled compared with conventional antiretroviral therapy for HIV infection. AIDS 16: 551ā560.
Marzolini C, Telenti A, Decosterd LA, Greub G, Biollaz J, Buclin T, 2001. Efavirenz plasma levels can predict treatment failure and central nervous system side effects in HIV-1-infected patients. AIDS 15: 71ā75.
World Health Organization, 2006. Antiretroviral therapy for HIV infection in adults and adolescents in resource-limited settings: towards universal access. Recommendations for a public health approach. Geneva, Switzerland: WHO.
Severe P, Leger P, Charles M, Noel F, Bonhomme G, Bois G, George E, Kenel-Pierre S, Wright PF, Galick R, Johnson WD Jr, Pape JW, Fitzgerald DW, 2005. Antiretroviral therapy in a thousand patients with AIDS in Haiti. N Engl J Med 353: 2325ā2334.
Leger P, Charles M, Severe P, Riviere C, Pape JW, Fitzgerald DW, 2009. 5-year survival of patients with AIDS receiving antiretroviral therapy in Haiti. N Engl J Med 361: 828ā829.
Parr JB, Sevilleja JE, Samie A, Alcantara C, Stroup SE, Kohli A, Fayer R, Lima AA, Houpt ER, Guerrant RL, 2007. Detection and quantification of Cryptosporidium in HCT-8 cells and human fecal specimens using real-time polymerase chain reaction. Am J Trop Med Hyg 76: 938ā942.
Samie A, Obi CL, Barrett LJ, Powell SM, Guerrant RL, 2007. Prevalence of Campylobacter species, Helicobacter pylori and Arcobacter species in stool samples from the Venda region, Limpopo, South Africa: studies using molecular diagnostic methods. J Infect 54: 558ā566.
Samie A, Obi CL, Tzipori S, Weiss LM, Guerrant RL, 2007. Microsporidiosis in South Africa: PCR detection in stool samples of HIV-positive and HIV-negative individuals and school children in Vhembe district, Limpopo Province. Trans R Soc Trop Med Hyg 101: 547ā554.
Samie A, Obi CL, Franasiak J, Rchbald-Pannone L, Bessong PO, Cantara-Warren C, Guerrant RL, 2008. PCR detection of Clostridium difficile triose phosphate isomerase (tpi), toxin A (tcdA), toxin B (tcdB), binary toxin (cdtA, cdtB), and tcdC genes in Vhembe District, South Africa. Am J Trop Med Hyg 78: 577ā585.
Sturbaum GD, Reed C, Hoover PJ, Jost BH, Marshall MM, Sterling CR, 2001. Species-specific, nested PCR-restriction fragment length polymorphism detection of single Cryptosporidium parvum oocysts. Appl Environ Microbiol 67: 2665ā2668.
Samie A, Obi CL, Dillingham R, Pinkerton RC, Guerrant RL, 2007. Enteroaggregative Escherichia coli in Venda, South Africa: distribution of virulence-related genes by multiplex polymerase chain reaction in stool samples of human immunodeficiency virus (HIV)-positive and HIV-negative individuals and primary school children. Am J Trop Med Hyg 77: 142ā150.
Rezk NL, Tidwell RR, Kashuba AD, 2003. Simultaneous determination of six HIV nucleoside analogue reverse transcriptase inhibitors and nevirapine by liquid chromatography with ultraviolet absorbance detection. J Chromatogr B Analyt Technol Biomed Life Sci 791: 137ā147.
Rezk NL, Crutchley RD, Yeh RF, Kashuba AD, 2006. Full validation of an analytical method for the HIV-protease inhibitor atazanavir in combination with 8 other antiretroviral agents and its applicability to therapeutic drug monitoring. Ther Drug Monit 28: 517ā525.
Leger P, Dillingham R, Beauharnais CA, Kashuba AD, Rezk NL, Fitzgerald DW, Pape JW, Haas DW, 2009. CYP2B6 variants and plasma efavirenz concentrations during antiretroviral therapy in Port-au-Prince, Haiti. J Infect Dis 200: 955ā964.
Durrer P, Zbinden R, Fleisch F, Altwegg M, Ledergerber B, Karch H, Weber R, 2000. Intestinal infection due to enteroaggregative Escherichia coli among human immunodeficiency virus-infected persons. J Infect Dis 182: 1540ā1544.
Wanke CA, Mayer H, Weber R, Zbinden R, Watson DA, Acheson D, 1998. Enteroaggregative Escherichia coli as a potential cause of diarrheal disease in adults infected with human immunodeficiency virus. J Infect Dis 178: 185ā190.
Yamamoto T, Echeverria P, Yokota T, 1992. Drug resistance and adherence to human intestines of enteroaggregative Escherichia coli. J Infect Dis 165: 744ā749.
Gassama A, AĆÆdara-Kane A, Chainier D, Denis F, Ploy MC, 2004. Integron-associated antibiotic resistance in enteroaggregative and enteroinvasive Escherichia coli. Microb Drug Resist 10: 27ā30.
Steiner TS, Lima AA, Nataro JP, Guerrant RL, 1998. Enteroaggregative Escherichia coli produce intestinal inflammation and growth impairment and cause interleukin-8 release from intestinal epithelial cells. J Infect Dis 177: 88ā96.
Roche JK, Cabel A, Sevilleja J, Nataro J, Guerrant RL, 2010. Enteroaggregative Escherichia coli (EAEC) impairs growth while malnutrition worsens EAEC infection: a novel murine model of the infection malnutrition cycle. J Infect Dis 202: 506ā514.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 33 | 33 | 10 |
Full Text Views | 243 | 66 | 0 |
PDF Downloads | 47 | 9 | 0 |