Diarrhea and reduced levels of antiretroviral drugs: Improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil

Oluma Y. Bushen, John A. Davenport, Afonso Bezerra Lima, Stephen C. Piscitelli, Arejas J. Uzgiris, Terezinha M.J. Silva, Roberio Leite, Margaret Kosek, Rebecca A. Dillingham, Arlete Girao, Aldo A.M. Lima, Richard L. Guerrant

Research output: Contribution to journalArticle

Abstract

The effects of therapy with glutamine and alanyl-glutamine on diarrhea and antiretroviral drug levels in patients with acquired immune deficiency syndrome (AIDS) were examined in a randomized, double-blinded, placebo-controlled study in northeast Brazil. Patients with AIDS and with diarrhea and/or wasting were randomized into 4 groups to determine the efficacy of glutamine or high- or low-dose alanyl-glutamine given for 7 days, compared with isonitrogenous glycine given to control subjects. All patients in whom baseline antiretroviral drug levels were determined had low levels 2 h after dosing. Gastrointestinal symptom scores improved with receipt of high-dose alanyl-glutamine (P<.05) or glutamine (P<.01). Antiretroviral drug levels increased in patients given alanyl-glutamine (P = .02) or glutamine (P = .03) by 113% (P = .02) and 14% (P = .01), respectively. Antiretroviral drug resistance mutations were common in all groups. The dose-related efficacy of alanyl-glutamine and glutamine in treating diarrhea and in increasing antiretroviral drug levels shows that these supplements may help to improve therapy for patients with AIDS who have diarrhea and/or wasting in developing, tropical areas.

Original languageEnglish (US)
Pages (from-to)1764-1770
Number of pages7
JournalClinical Infectious Diseases
Volume38
Issue number12
DOIs
StatePublished - Jun 15 2004
Externally publishedYes

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Bushen, O. Y., Davenport, J. A., Lima, A. B., Piscitelli, S. C., Uzgiris, A. J., Silva, T. M. J., Leite, R., Kosek, M., Dillingham, R. A., Girao, A., Lima, A. A. M., & Guerrant, R. L. (2004). Diarrhea and reduced levels of antiretroviral drugs: Improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil. Clinical Infectious Diseases, 38(12), 1764-1770. https://doi.org/10.1086/421394