Bile acid malabsorption in AIDS-associated chronic diarrhea: a prospective 1-year study.

Abstract

In patients with chronic diarrhea associated with acquired immunodeficiency syndrome, bile acid malabsorption, very rarely investigated, may have an important pathogenetic role. In this 1-yr prospective study, 15 patients with AIDS-associated chronic diarrhea and 10 AIDS-controls were studied for bile acid malabsorption by means of the SeHCAT abdominal retention test. The patients with diarrhea underwent the glucose hydrogen breath test to identify any bacterial proliferation in the small bowel. 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. Among the controls, only one had an abnormal low SeHCAT retention. In both cases with Cryptosporidium infection, the SeHCAT test was pathological. These data are of clinical importance for the pathogenetic study of AIDS-associated chronic diarrhea and for specific treatment with cholestyramine.