NATURAL-HISTORY AND PROGNOSIS OF DIARRHEA OF UNKNOWN CAUSE IN PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME (AIDS)

This paper is a prospective study of patients with advanced human immu nodeficiency virus infection and chronic diarrhoea for which no cause could be found after extensive investigations, including examination o f multiple stool specimens for all known faecal pathogens and the hist ological examination of small and large bowel biopsy specimens. Of 39 such patients recruited from 155 prospectively investigated patients, eight had a possible cause of diarrhoea identified on follow up invest igations, including small bowel neoplasms in three and cytomegalovirus in two. In 17 of the remaining 31 the diarrhoea resolved completely i n a mean of seven months from its onset. Eleven had continuing mild or intermittent diarrhoea and three had more than 1 litre of diarrhoea d aily for which no cause could be found. The median survival for patien ts with 'pathogen negative' diarrhoea was 48.7 months, which is simila r to that of control patients with no diarrhoea and significantly long er than that of matched patients with a gastrointestinal pathogen (9.6 months).