Chronic Non-Infectious Diarrhea in HIV-infected Persons

Abstract

Chronic non-infectious diarrhea is estimated to occur in approximately 5% of all HIV-infected persons in the United States.  The two main etiologies are HIV enteropathy and antiretroviral- associated diarrhea.  The initial evaluation should focus on determining if the diarrhea is truly chronic, and excluding infectious etiologies.  Treatment options for chronic non-infectious diarrhea are limited, but there is one FDA-approved drug (crofelemer) specifically approved for use in this setting.  In addition, powdered serum bovine immunoglobulin (a “medical food” per the FDA) shows promise, but studies in humans have been small.  This brief article will review the etiology, diagnosis, evaluation, and management of this condition.