P. Kelly et al., ALBENDAZOLE CHEMOTHERAPY FOR TREATMENT OF DIARRHEA IN PATIENTS WITH AIDS IN ZAMBIA - A RANDOMIZED DOUBLE-BLIND CONTROLLED TRIAL, BMJ. British medical journal, 312(7040), 1996, pp. 1187-1191
Objective-To determine the value of short course, high dose albendazol
e chemotherapy in the treatment of persistent diarrhoea related to HIV
in unselected patients in urban Zambia. Design-A randomised double bl
ind placebo controlled trial of albendazole 800 mg twice daily for two
weeks. Patients were monitored intensively for one month and followed
for up to six months. Setting-Home care AIDS services in Lusaka and N
dola. Patients-174 HIV seropositive patients with persistent diarrhoea
(defined as loose but not bloody stools three or more times a day for
three weeks or longer). No investigations were undertaken except HIV
testing after counselling. Main outcome measures-Proportion of time pe
riods during which diarrhoea was experienced after completion of treat
ment; proportion of patients with full remission after completion of t
reatment; mortality. Results-The patients taking albendazole had diarr
hoea on 29% fewer days than those taking placebo (P<0.0001) in the two
weeks after treatment. The benefit of albendazole was maintained over
six months. In patients with a Karnofsky score of 50 to 70 (needing h
elp with activities of daily living and unable to work, but not needin
g admission to hospital) diarrhoea was reduced by 50%. Remission was o
btained in 26% of all patients who received albendazole (P=0.004 again
st 9% receiving placebo), and this difference was maintained over six
months (log rank test, P=0.003). Albendazole had no effect on mortalit
y. Minimal adverse effects were noted. Conclusions-For HIV infected Za
mbians with diarrhoea of more than three weeks' duration albendazole o
ffers substantial relief from symptoms and may be used empirically, wi
thout prior investigation.