Diarrhea and Reduced Levels of Antiretroviral Drugs: Improvement with Glutamine or Alanyl-Glutamine in a Randomized Controlled Trial in Northeast Brazil

The effects of therapy with glutamine and alanyl-glutamine on diarrhea and antiretroviral drug levels in patients with acquired immune deficiency syndrome (AIDS) were examined in a randomized, double-blinded, placebo-controlled study in northeast Brazil. Patients with AIDS and with diarrhea and/or w...

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Bibliographic Details
Published in:	Clinical infectious diseases Vol. 38; no. 12; pp. 1764 - 1770
Main Authors:	Bushen, Oluma Y., Davenport, John A., Lima, Afonso Bezerra, Piscitelli, Stephen C., Uzgiris, Arejas J., Silva, Terezinha M. J., Leite, Roberio, Kosek, Margaret, Dillingham, Rebecca A., Girao, Arlete, Lima, Aldo A. M., Guerrant, Richard L.
Format:	Journal Article
Language:	English
Published:	Chicago, IL The University of Chicago Press 15-06-2004 University of Chicago Press
Subjects:	Acquired Immunodeficiency Syndrome - blood Acquired Immunodeficiency Syndrome - complications Acquired Immunodeficiency Syndrome - drug therapy Adult AIDS Anti-HIV Agents - blood Anti-HIV Agents - pharmacokinetics Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral Therapy, Highly Active Antiretrovirals Antiviral agents Antivirals Biological and medical sciences Brazil Control groups Diarrhea Diarrhea - drug therapy Diarrhea - etiology Dipeptides - therapeutic use Dosage Drug Resistance, Viral - genetics Excretion Female Gin Glutamine - therapeutic use HIV HIV - genetics HIV Wasting Syndrome - blood HIV Wasting Syndrome - drug therapy HIV/AIDS Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Middle Aged Pharmacology. Drug treatments Pilot Projects Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viruses South America Brazil America Antiretroviral agent Check Gastrointestinal Glycine Prevention Intestinal disease Antiviral High dose Human Immunopathology Treatment resistance Low dose Weight loss Diarrhea AIDS Concentration Immune deficiency Infection Symptomatology Treatment Denutrition Aminoacid Viral disease Digestive diseases Pharmacokinetics Comparative study Glutamine
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Summary:	The effects of therapy with glutamine and alanyl-glutamine on diarrhea and antiretroviral drug levels in patients with acquired immune deficiency syndrome (AIDS) were examined in a randomized, double-blinded, placebo-controlled study in northeast Brazil. Patients with AIDS and with diarrhea and/or wasting were randomized into 4 groups to determine the efficacy of glutamine or high- or low-dose alanyl-glutamine given for 7 days, compared with isonitrogenous glycine given to control subjects. All patients in whom baseline antiretroviral drug levels were determined had low levels 2 h after dosing. Gastrointestinal symptom scores improved with receipt of high-dose alanyl-glutamine (P < .05) or glutamine (P < .01). Antiretroviral drug levels increased in patients given alanyl-glutamine (P = .02) or glutamine (P = .03) by 113% (P = .02) and 14% (P = .01), respectively. Antiretroviral drug resistance mutations were common in all groups. The dose-related efficacy of alanyl-glutamine and glutamine in treating diarrhea and in increasing antiretroviral drug levels shows that these supplements may help to improve therapy for patients with AIDS who have diarrhea and/or wasting in developing, tropical areas.
Bibliography:	istex:6BE5475B506EB221B2B3706D359017621FA5D7F1 ark:/67375/HXZ-17QNXGWW-8 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 ObjectType-News-3
ISSN:	1058-4838 1537-6591
DOI:	10.1086/421394