Differences in Rates of Diarrhea in Patients with Human Immunodeficiency Virus Receiving Lopinavir‐Ritonavir or Nelfinavir

Abstract

Patients receiving lopinavir-ritonavir were significantly less likely to have diarrhea or to require treatment for diarrhea than patients receiving nelfinavir. The same results occurred when the drugs were given to the same patients sequentially (nelfinavir followed by lopinavir-ritonavir). The diarrhea associated with lopinavir-ritonavir was less frequent, less severe, and shorter in duration than diarrhea associated with nelfinavir.

Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients

“…Diarrhea in the setting of HIV infection may have many causes; it may be a consequence of HAART [44] , the HIV infection itself or may result from any bacterial, viral or parasitic infection [45] . Currently, HAART-induced diarrhea is the primary reason for the continually high prevalence of diarrhea in HIV-infected patients, especially with the use of protease inhibitors [46] .…”

Gastrointestinal complications of HIV infection: changing priorities in the HAART era

“…Drug-induced diarrhoea has been most frequently attributed to the protease inhibitors, and studies suggest that diarrhoea occurs in up to 50% of patients taking nelfinavir and in up to 20% of those taking lopinavir/ritonavir and fosamprenavir/ritonavir 56. Often there is a temporal association between drug initiation and diarrhoea, and typically the diarrhoea is of mild to moderate severity.…”

Understanding and Avoiding Antiretroviral Adverse Events

“…Atazanavir has an incidence of 1-3% [72], and fosamprenavir has an incidence of 5-13% [73]. In a retrospective cohort study lopinavir/ritonavir actually had significantly less diarrhea when compared to nelfinavir [74]; yet, for both drugs diarrhea is listed in the package insert as the most common side effect [75,76]. Clinically, it is common for a given patient to have varying degrees of diarrhea with different PIs.…”