Anwar D, Hogan S, Thompson S, Wilcox M, Schwartz D, Bryan R; National Conference on Human Retroviruses and Related Infections.
Program Abstr Second Natl Conf Hum Retrovir Relat Infect Natl Conf Hum Retrovir Relat Infect 2nd 1995 Wash DC. 1995 Jan 29-Feb 2; 111.
Emory University School of Medicine (Grady Memorial Hospital), Atlanta, GA.
The aim of this study is to determine the clinical and microbiological effectiveness of atovaquone for treatment (Tx) of gastrointestinal microsporidiosis (micro) in AIDS patients. Eight male homosexual patients with AIDS (mean CD4 count 29/mm3 +/- 11 SEM), in whom micro was detected in fresh stools by the Weber-chromotrope-based stain, were given atovaquone 750 mgs. TID, after exclusion of other diarrhea etiologies by an extensive work-up. Four patients had additional confirmatory duodenal or jejunal biopsies (E. bieneusis by EM). Monthly clinical and stool examinations were performed. At the initiation of the Tx, the mean number of stools/day was 10 +/- 2.5 SEM, with liquid consistency. All patients experienced clinical improvement, with the mean beginning after 13 days (+/- 2 SEM) of Tx; mean weight gain was 9.5 pounds +/- 5 SEM after 1-6 months, and the stools decreased to mean 3/day +/- 1 SEM (p=0.02, paired t-test). The stool exams showed persistent but decreased numbers of micro. On acontrol jejunal biopsy, one patient always had micro, but they were few in number; another had drastic changes in protozoal parasite morphology. These preliminary data suggest that patients with micro may clinically respond to atovaquone, even if the organism is not eradicated. Thus, in this debilitating diarrheal disease, atovaquone may be the only useful therapeutic agent now available, at least for E. bieneusi. Further prospective studies including placebo control, microbiological and anatomo-pathological evaluation are warranted.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Atovaquone
- CD4 Lymphocyte Count
- Duodenum
- Feces
- Homosexuality, Male
- Humans
- Intestines
- Male
- Microsporidiosis
- Naphthoquinones
- Prospective Studies
- therapy
Other ID:
UI: 102213289
From Meeting Abstracts