|Chronic Diarrhea: Margin for Improvement? DIACRO Study|| |
|J. Sanz1, M. Palazuelos2, H. Hevia2, F. Ledesma2|
|1Hospital Universitario de la Princesa, Madrid, Spain, 2Janssen, Medical Department, Madrid, Spain|
|Objective: Chronic diarrhea has been historically a frequent disorder within the HIV-infected population. The objective of the DIACRO study was to identify the current prevalence of chronic diarrhea, its cause and clinical management within HIV-infected patients. |
Methods: Cross-sectional study performed in 40 Spanish hospitals. HIV-infected patients that attended the HIV clinic in May-June 2012 and signed informed consent went through a 5 question screening test. Those patients who marked positively having ≥ 2 stools/day and bowel movement disturbance > 1 month plus another positive question of 5 (increase in bowel volume/frequency within the last month, loose faeces or having had to abandon activities urgently to defecate within the last 15 days) were considered as chronic diarrhea patients. Patient information was collected from medical records.
Results: The study included 2.658 patients. According to the study definition, the prevalence of chronic diarrhea was 10.3%. 62.3% of these patients did not report diarrhea proactively to their physicians. 72% of them had to abandon urgently their activities to defecate in the previous 15 days. 17.6% of the chronic diarrhea patients declared having ≥ 4 stools/day and 76.2% suffered from bowel movement disturbance > 6 months. Physicians related the chronic diarrhea appearance to the ARV therapy in half of the cases. Within this population the risk of having chronic diarrhea was five times higher with PI/r BID than with other ARVs[(OR(CI 95%)=5.53(3.09-10.09)]. There were significantly more palliative measures and treatment adjustments within PI/r BID patients than within the rest of treatments.
Conclusion: Chronic diarrhea remains a common problem in the HIV-infected population. Taking into account that most of the patients do not proactively communicate its presence, a simple medical/case history could help to identify the underlying chronic diarrhea. PI/r BID-based regimens may have an important role in the ARV-related diarrhea cases.
Jesús Sanz , Hospital Universitario de la Princesa , Madrid , Spain
Assigned in sessions:
17.10.2013, 12:00-14:00, Poster Session, Poster Session 1, Exhibition
18.10.2013, 12:00-14:00, Poster Session, Poster Session 2, Exhibition