Diarrhea and reduced levels of antiretroviral drugs: improvement with glutamine or alanyl-glutamine in a randomized controlled trial in northeast Brazil

OY Bushen, JA Davenport, AB Lima… - Clinical Infectious …, 2004 - academic.oup.com
OY Bushen, JA Davenport, AB Lima, SC Piscitelli, AJ Uzgiris, TMJ Silva, R Leite, M Kosek
Clinical Infectious Diseases, 2004academic.oup.com
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 …
Abstract
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.
Oxford University Press