Etiology and pharmacologic management of noninfectious diarrhea in HIV-infected individuals in the highly active antiretroviral therapy era

Louis D. Saravolatz, Rodger D. MacArthur, Herbert L. Dupont

Research output: Contribution to journalReview article

45 Scopus citations


Diarrhea remains a common problem for patients with human immunodeficiency virus (HIV) infection despite highly active antiretroviral therapies (HAART) and can negatively affect patient quality of life and lead to discontinuation or switching of HAART regimens. In the era of HAART, diarrhea from opportunistic infections is uncommon, and HIV-associated diarrhea often has noninfectious causes, including HAART-related adverse events and HIV enteropathy. Diarrhea associated with HAART is typically caused by protease inhibitors (eg, ritonavir), which may damage the intestinal epithelial barrier (leaky-flux diarrhea) and/or alter chloride ion secretion (secretory diarrhea). HIV enteropathy may result from direct effects of HIV on gastrointestinal tract cells and on the gastrointestinal immune system and gut-associated lymphoid tissue, which may be active sites of HIV infection and ongoing inflammation and mucosal damage. New therapies targeting the pathogenic mechanisms of noninfectious diarrheas are needed.

Original languageEnglish (US)
Pages (from-to)860-867
Number of pages8
JournalClinical Infectious Diseases
Issue number6
Publication statusPublished - Sep 1 2012
Externally publishedYes


ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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