Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024523 (malabsorption)
 7,319 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Micronutrient deficiencies may be common during human immunodeficiency virus (HIV) infection. Insufficient dietary intake, malabsorption, diarrhoea, and impaired storage and altered metabolism of micronutrients can contribute to the development of micronutrient deficiencies. Low plasma or serum levels of vitamins A, E, B6, B12 and C, carotenoids, Se, and Zn are common in many HIV-infected populations. Micronutrient deficiencies may contribute to the pathogenesis of HIV infection through increased oxidative stress and compromised immunity. Low levels or intakes of micronutrients such as vitamins A, E, B6 and B12, Zn and Se have been associated with adverse clinical outcomes during HIV infection, and new studies are emerging which suggest that micronutrient supplementation may help reduce morbidity and mortality during HIV infection.
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PMID:Micronutrients and the pathogenesis of human immunodeficiency virus infection. 1043 44

Weight loss late in the course of human immunodeficiency virus (HIV) disease is common and often multifactorial. Increased energy expenditure in response to opportunistic disease, as well as to HIV infection itself, can lead to protein-calorie malnutrition similar to that observed in starvation. Weight loss of as little as 5 percent in patients with HIV infection is associated with an increased risk of disease progression. Loss of body cell mass carries a particularly poor prognosis, and aggressive measures should be taken to stop such depletion. Patients exhibiting unexpected weight loss should be carefully examined to exclude decreased food intake, malabsorption, occult infection or neoplasm as the etiology of the weight loss. Early aggressive treatment of HIV disease and underlying opportunistic pathology, along with adequate pharmacologic, hormonal, nutritional and physical therapy, can often restore normal weight and body composition.
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PMID:Evaluation and treatment of weight loss in adults with HIV disease. 1049 11

Weight loss, anorexia, metabolic disorder and malabsorption are leading symptoms of HIV infection. Recent data help us to understand wasting as being intrinsically linked to immunodysregulation and enteropathy. In therapy, the role played by anabolic steroids and growth hormone has been newly defined. The new antiviral drugs may efficiently prevent clinical progression, including wasting. New metabolic side effects have, however, been encountered.
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PMID:HIV infection and malnutrition. 1056 77

Micronutrient deficiencies are common in HIV/AIDS, resulting from both malabsorption and virally-caused depletion. Beta carotene and selenium deficiencies, two of the most common nutrient deficiencies, are important due to their dual function as nutrients necessary for immune modulation and as antioxidants. Beta carotene deficiencies are common in all stages of HIV/AIDS and may signal malabsorption. Supplementation has been shown to affect specific T lymphocyte populations and decrease markers of lipoperoxides. Selenium levels are highly significant in predicting AIDS-related mortality; and the HIV virus manufactures selenoproteins that are involved in the regulation of viral replication, possibly depleting host levels of selenium. Supplementation trials with individual antioxidants have shown improvement in immunological parameters and decreased evidence of lipid peroxidation.
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PMID:Nutrients and HIV: part one -- beta carotene and selenium. 1060 13

Malnutrition is common among individuals suffering from hypoxemic chronic obstructive pulmonary disease (COPD), advanced HIV disease, and in patients with chronic, severe congestive heart failure. Although increased morbidity and mortality has been associated with weight loss in these conditions, the pathophysiology of malnutrition remains somewhat unclear for each. In COPD, the primary postulated mechanism is hypermetabolism resulting in elevated total caloric expenditure arising from increased airway resistance, increased O2 cost of ventilation, increased dietary induced thermogenesis, inefficient substrate use and perhaps, increased levels of proinflammatory cytokines. In AIDS, postulated mechanisms include hypermetabolism arising from increased activation of proinflammatory cytokines, along with futile cycling of fatty acids and de novo lipogenesis early in the course of HIV infection; intestinal malabsorption and anorexia also play a role in many inflicted individuals. In cardiac cachexia, dietary and metabolic factors, and levels and activity of cytokines, thyroid hormone, catecholamines and cortisol have been suggested as being responsible for causing weight loss in a most cases.
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PMID:Tissue wasting in patients with chronic obstructive pulmonary disease. 1065 78

Oral ganciclovir has been used as prophylaxis and therapy against cytomegalovirus in patients with HIV infection and following organ transplantation. Oral ganciclovir has clear practical advantages over intravenous ganciclovir but has a relatively low bioavailability and this may be problematic in at-risk patients with malabsorption. The bioavailability and therefore therapeutic potential of oral ganciclovir in cystic fibrosis (CF) patients post-lung transplant (LT) might be expected to be inadequate given the high incidence of malabsorption in these patients. An 8 h pharmacokinetic study was performed in 12 CF patients 160 +/- 122 days post-transplant who had been taking 1 g oral ganciclovir tds for 3 days with food (plus normal enzyme supplements). Mean (range) serum creatinine was 150 Imol/L (70-280). Blood was sampled at 0.5, 1, 2, 3, 4, 6 and 8 h post-final dose. Plasma was stored at -20 degrees C and later analysed by highperformance liquid chromatography. Mean peak concentration (C(max)) was 4.8 mg/L (0. 96-12.8), mean minimum concentration (C(min)) was 3.6 mg/L (0.78-11. 7) and mean area under the curve (AUC) was 35.4 mg.8 h/L (8-99). C(max), C(min) and AUC correlated significantly with one another (P < 0.001) as well as with serum creatinine and creatinine clearance (P < 0.01). When corrected for alterations in renal function, plasma oral ganciclovir levels are as predicted for other transplant populations. Three days of oral ganciclovir results in therapeutically useful plasma drug levels in the CF LT population, despite a background of general malabsorption. C(max), C(min) and AUC are highly correlated, allowing for the possibility of steady-state drug monitoring to confirm that the recommended dosing algorithm produces appropriate plasma levels.
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PMID:Pharmacokinetic assessment of oral ganciclovir in lung transplant recipients with cystic fibrosis. 1074 29

The nutritional condition of children with human immunodeficiency virus (HIV) infection continues to be a problem both in developed and developing countries. HIV-infected children grow below normal standards in both height and weight when compared with HIV-exposed non-infected children. These patterns persist over time. It is possible that acute infectious episodes and increased HIV viral burden contribute to decrements in all growth variables. Potential aetiologies for abnormal growth include inadequate dietary intake, gastrointestinal malabsorption, increased energy utilization and psycho-social problems. It is likely that all these factors contribute to the growth problems of these children to some extent. With the development of protease inhibitor anti-retroviral therapy and highly-active anti-retroviral treatment regimens, children with HIV infection in developed countries are living longer with a chronic illness. New nutritional problems have arisen with the development of the fat redistribution syndrome or lipodystrophy. Emerging problems are now being recognized, with the development of insulin resistance and truncal obesity which may potentially lead to premature cardiovascular disease.
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PMID:Nutrition in paediatric human immunodeficiency virus infection. 1082 85

The aim of this study was to evaluate fat absorption in HIV-positive (HIV+) patients in different phases of HIV infection using a 14C-triolein breath test. We distributed 47 HIV+ patients according to the 1993 Centers for Disease Control Revised Classification: 20 in Group 2 (A1 or A2) and 27 in Group 3 (B1, B2, A3, B3, or C). Ten HIV-negative healthy subjects comprised the control group (Group 1). All individuals underwent a 14C-triolein breath test. Parasitic infection was evaluated through three stool exams, including Cryptosporidium and Isospora investigation. The median value of cumulative 6 hours' 14C excretion expressed as percentage of the 14C given as triolein was significantly higher in Group 1 (8.4%) than Group 2 (5.5%) or Group 3 (3.4%), p = 0.04 and p << 0.01, respectively. Fat malabsorption was found in 25% of Group 2 individuals, 52.6% of those without diarrhea in Group 3, and was correlated with CD4+ lymphocyte counts (p << 0.01). Fat malabsorption is a common feature in advanced stages of HIV infection, even in the absence of diarrhea and is also present in asymptomatic HIV+ patients. These findings suggest that malabsorption is an early event in HIV-infected individuals and is correlated with the degree of immunosuppression.
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PMID:Fat malabsorption assessed by 14C-triolein breath test in HIV-positive patients in different stages of infection: is it an early event? 1087 69

Poor growth is reported in as many as 50% of HIV-infected children. HIV infection adversely affects pregnancy outcome; infants born to HIV-infected women have significantly lower mean birth weight and length, regardless of the infants' HIV status, compared with infants born to uninfected women. Pediatric HIV further reduces birth weight. Progressive stunting, that is, proportionately decreased linear and ponderal growth, appears to be the most common abnormality in perinatally infected children and is accompanied by preferential decreases of fat-free or lean body mass. Although data are inconsistent, deficiencies of several micronutrients with the potential to affect growth adversely have been identified, including that of vitamin A. Neuroendocrine abnormalities also occur, including abnormal thyroid, growth hormone/ insulinlike growth factor-1, and adrenal function; however, no consistent endocrine abnormality is observed in HIV-associated growth failure. Infections of the gastrointestinal tract and malabsorption of carbohydrates, fat, and protein are common, but no relationship between these disorders and poor growth has been demonstrated. Despite normal rates of resting and total energy expenditures, the mean daily dietary intake of children with growth failure (GF) appears to be inadequate. Inadequate dietary intake is not the sole cause of GF; dietary supplementation improves weight but does not correct deficits in lean tissue or height. Levels of HIV RNA are greater in children with poor growth compared with infected children with normal rates of growth. How HIV replication impedes growth has not been established but suppression of HIV appears to have a favorable effect on ponderal and linear growth. Further investigations are necessary to evaluate the potential role of anabolic agents for the management of HIV-associated growth failure.
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PMID:Growth failure in children with HIV infection. 1112 24

Diarrhea and malabsorption due to intestinal dysfunction are common symptoms in HIV infection. The pathophysiologic mechanisms of these alterations are often not known, and the role of HIV per se is still controversially discussed. We measured the epithelial transport and barrier function by means of a miniaturized Ussing chamber system in the duodenum of HIV-infected patients in different disease stages, determined by the CD4 cell count in the serum as well as symptoms in patients with and without diarrhea. We could show that diarrhea induced by HIV per se is caused by a leak flux mechanism due to impaired epithelial barrier function. Antisecretory therapy does not seem to be useful in these patients, because we did not find increased active ion secretion. Along the course of the HIV infection, the epithelial transport and barrier function varies with HIV disease stage (expressed by CD4 cell status). In addition, an in vitro model was studied to characterize the effect of HIV-infected human immune cells on the epithelial barrier function using the human colonic epithelial cell line HT-29/B6. HIV infection of human immune cells induced an increase in cytokine release--for example, TNF-alpha, IL-1 beta, IFN-alpha, and IFN-gamma--downregulating the epithelial barrier function of the human colonic epithelial cell line HT-29/B6. Taken together we postulate a specific stage-dependent cytokine pattern released from HIV-infected immune cells in the mucosa, which, corresponding to the HIV disease stage, is responsible for the variation in epithelial function.
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PMID:Mechanisms of epithelial barrier impairment in HIV infection. 1119 91


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