Dieterich D, Kotler D, Lafleur F, Lew E, Orenstein J; International Conference on AIDS.

Int Conf AIDS. 1992 Jul 19-24; 8: B142 (abstract no. PoB 3333).

New York University Medical Center, New York.

OBJECTIVE: To determine the efficacy of albendazole treatment of intestinal microsporidiosis in people with HIV. METHODS: Thirteen HIV-infected patients were studied. All had severe diarrhea greater than 6 BM's/day, weight loss greater than 10 lbs, and evidence of malabsorption. All patients had the diagnosis of microsporidiosis made on small bowel biopsy which was confirmed by electron microscopy (E.M.). Twelve out of thirteen patients had Enterocytozoon bieneusi, whereas one patient had a newly described species that was found in the urine and small bowel biopsy. Patients were treated with albendazole 400 mg po bid for one month. They underwent repeat small bowel biopsy and had diarrhea evaluated. RESULTS: Thirteen patients in all were treated. Median age was 40. All had T cells less than 200. As of this writing, seven are evaluable. One patient died of bacterial sepsis after 1 week of therapy. Two other patients also died (after 6 months and 1 month of therapy). The one patient with the new species cleared microsporidia from the small bowel biopsy, but had only a minor decrease in diarrhea. Five of the six remaining patients (83%) all had dramatic reductions in diarrhea while still showing some evidence of infection on E.M. of small bowel biopsy. Diarrhea appeared to have returned when treatment was stopped. Evaluation with repeat biopsies during continued treatment is ongoing. A method to quantitate biopsy results is under development. There were no adverse events associated with albendazole. CONCLUSIONS: Albendazole appears to be a safe and effective treatment for 2 species of microsporidiosis in HIV patients. A double-blind placebo controlled study with pharmacokinetics is presently underway. Stool tests for microsporidia and E.M. quantitative methods are under development.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Albendazole
• Diarrhea
• Duodenum
• Enteritis
• Enterocytozoon
• Feces
• HIV Infections
• HIV Seropositivity
• Humans
• Intestinal Diseases, Parasitic
• Intestine, Small
• Microsporidiosis
• diagnosis
• therapy

Other ID:

• 92401061

UI: 102198774

From Meeting Abstracts