TY - JOUR
T1 - Diarrhea and reduced levels of antiretroviral drugs
T2 - Improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil
AU - Bushen, Oluma Y.
AU - Davenport, John A.
AU - Lima, Afonso Bezerra
AU - Piscitelli, Stephen C.
AU - Uzgiris, Arejas J.
AU - Silva, Terezinha M.J.
AU - Leite, Roberio
AU - Kosek, Margaret
AU - Dillingham, Rebecca A.
AU - Girao, Arlete
AU - Lima, Aldo A.M.
AU - Guerrant, Richard L.
N1 - Funding Information:
Financial support. This study was supported in part by the University of Virginia Deans Geographic Medicine Scholarship (to J.A.D.), by Baxter Healthcare (Baxter-08012001), and by a National Institutes of Health (NIH) International Collaboration in Infectious Disease Research grant (grant no. 5 U01 AI 26512-14). O.Y.B. and R.A.D. were supported by an NIH training grant (grant no. 2 T32 AI 07046), and M.K. was supported by an NIH training grant (grant no. T 32 AI 107496-06) to the University of Virginia Beirne B. Carter Center for Immunology Research.
PY - 2004/6/15
Y1 - 2004/6/15
N2 - 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.
AB - 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.
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U2 - 10.1086/421394
DO - 10.1086/421394
M3 - Article
C2 - 15227625
AN - SCOPUS:2942656778
SN - 1058-4838
VL - 38
SP - 1764
EP - 1770
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 12
ER -