HIV-associated diarrhoea and wasting : Report of a meeting at the University of Texas Medical School at Houston

Chronic diarrhoea and weight loss commonly complicate the course of HIV infection and AIDS. The broad range of potential aetiological agents in HIV-infected patients with diarrhoea, the cost of the various tests required to detect these agents, and the variable response to treatment in these patients make the approach to HIV-associated diarrhoea complex and confusing. Weight loss and cachexia may occur with diarrhoea or in association with other HIV-associated infections and disorders. Both acute and chronic diarrhoea are seen commonly in HIV-infected persons living in Europe and the United States. Wasting commonly occurs with or without diarrhoea in advanced HIV disease. A syndrome of chronic diarrhoea (more than 30 days) and important weight loss (reduction of 10% or more of normal weight) is one of the major manifestations of AIDS in Africa; the syndrome is referred to as slim disease. The patient presented here illustrates how difficult it is to establish the cause of diarrhoea in an HIV-infected patient and to reach a satisfactory management plan.