Diarrhoea and weight loss are found in more than 50% of patients with the acquired immunodeficiency syndrome (AIDS). In some patients the symptoms can be very severe, leading to death even in the absence of opportunistic infections. In 30% of these patients, enteric pathogens cannot be identified, and approximately only half of the identifiable aetiologic agents of diarrhoea in patients infected with the human immunodeficiency virus (HIV) were treatable with antibiotics. Immunoglobulins from bovine colostrum (Lactobin, Biotest, Dreieich, FRG) contain high titers of antibodies against a wide range of bacterial, viral and protozoal pathogens as well as against various bacterial toxins. Lactobin (LIG) is quite resistant to 24-h incubation with gastric juice. In a multi-center pilot study 37 immunodeficiency patients with chronic diarrhoea [29 HIV-infected patients, 2 patients with common variable immunodeficiency (CVID), one unidentified immunodeficiency, five patients with graft versus host disease (GvHD) following bone marrow transplantation] were treated with oral LIG (10 g/day for 10 days). Good therapeutic effects were observed. Out of 31 treatment periods in 29 HIV-infected patients 21 gave good results leading to transient (10 days) or long-lasting (more than 4 weeks) normalisation of the stool frequency. The mean daily stool frequency decreased from 7.4 to 2.2 at the end of the treatment. Eight HIV-infected patients showed no response. The diarrhoea recurred in 12 patients within 4 weeks (32.4%), while 19 patients were free of diarrhoea for at least 4 weeks (51.3%). In 5 patients intestinal cryptosporidiosis disappeared following oral LIG treatment. LIG treatment was also beneficial in 4 out of 5 GvHD patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral manifestations were studied in 87 HIV-positive Thai adults (study 1), 45 HIV-positive children (study 2) and 101 HIV-positive (study 3). In study 1, 48% of patients had oral lesions; 23% had one and 13.8% two oral manifestations. Oral pseudomembranous candidiasis was found in 10.3%, erythematous candidiasis in 6.9%, and hairy leukoplakia (HL) in 11.5% of the patients. In study 2, 24.4% of children revealed one, 17.8% two and 6.6% three oral lesions; erythematous candidiasis was seen in 17.8%, and HL in 6.7% of the children. Fifteen patients (33.3%) received antiretroviral therapy. In study 3, pseudomembranous candidiasis was found in 52.5%, HL in 35.6% and necrotizing gingivo-periodontitis in 27.7%. Only 10% of patients were without oral lesions. The present three studies among HIV-infected Thai and Cambodians indicated a high prevalence of oral lesions, particularly variants of oral candidiasis such as pseudomembranous and erythematous candidiasis. Also, oral HL was a common finding, more so in patients with AIDS-associated diseases as represented by patients of study 3. Oral candidiasis and oral HL also seem to be quite prevalent in pediatric HIV-infected patients. In the absence of parameters indicating the degree of immunosuppression (CD4(+) cell counts and viral load) these oral lesions may be considered strong indicators of HIV-associated immunodeficiency.

The general health status of 101 Cambodian patients with HIV infection and AIDS was poor, and they demonstrated a large number of oral manifestations. Antiretroviral therapy is presently not available and only a fraction of patients receives antimycotic treatment (25.7%). HIV infection and the AIDS epidemic in Cambodia have become a serious problem and patients urgently need adequate diagnosis and antiretroviral therapies.

This study indicates high oral yeast carriage in leprosy patients. Candida albicans remains predominant while C. krusei and C. glabrata are second-line oral colonizers. Co-inhabitation of multiple yeast species is also noted in these patients' oral mycotic flora.