BILE-ACID MALABSORPTION IN AIDS-ASSOCIATED CHRONIC DIARRHEA - A PROSPECTIVE 1-YEAR STUDY

Objectives: In patients with chronic diarrhea associated with acquired immunodeficiency syndrome, bile acid malabsorption, very rarely inves tigated, may have an important pathogenetic role. Methods: In this 1-y r prospective study, 15 patients with AIDS-associated chronic diarrhea and 10 AIDS-controls were studied for bile acid malabsorption by mean s of the SeHCAT abdominal retention test. The patients with diarrhea u nderwent the glucose hydrogen breath test to identify any bacterial pr oliferation in the small bowel. Results: In the chronic diarrhea group , only one case of small bowel bacterial overgrowth, and seven cases ( 47%) with generally severe bile acid malabsorption, were observed. Amo ng the controls, only one had an abnormal low SeHCAT retention. In bot h cases with Cryptosporidium infection, the SeHCAT test was pathologic al. Conclusions: These data are of clinical importance for the pathoge netic study of AIDS-associated chronic diarrhea and for specific treat ment with cholestyramine.