Johns Hopkins HIV Guide
Diarrhea
Diarrhea is a topic covered in the Johns Hopkins HIV Guide.
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PATHOGENS
- HIV disease profoundly affects the gut and may manifest as diarrheal illness. HIV enteropathy is recognized by villous atrophy, crypt hyperplasia, and villous blunting and lymphocytes infiltration in the lamina propria.[14]
- HIV-associated alterations in mucosal immunity may predispose those with HIV to enteric bacterial infections.[7]
- Risk factors that contribute to HIV acquisition may increase risk of exposure to sexually transmitted infections that may manifest as enteritis or proctitis.[1]
- Advanced HIV/AIDS broadens the number of etiologic agents to include opportunistic infections that cause diarrhea.[13]
- Acute: Salmonella, Shigella, Campylobacter, Clostridium difficile, E. coli (enteroaggregative EAEC), S. aureus, Vibrio parahemolyticus, Yersinia, norovirus[9] and other viruses (calicivirus, astrovirus, adenovirus).
- Chronic: Cryptosporidium, microsporidia, MAC, CMV, Cyclospora, Giardia, Cystoisospora, Entamoeba histolytica, Strongyloides, HIV enteropathy, and the causes of acute diarrhea listed above, especially Salmonella.
- CD4 < 50: Cryptosporidium,microsporidia, CMV, MAC.
- Pathogen-negative, chronic, large-volume diarrhea: KS or lymphoma.
- Non-infectious causes: adverse drug reactions, inflammatory bowel disease, dietary (milk, sorbitol, caffeine), malabsorption, exocrine pancreatitic insufficiency, endocrine disease.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
PATHOGENS
- HIV disease profoundly affects the gut and may manifest as diarrheal illness. HIV enteropathy is recognized by villous atrophy, crypt hyperplasia, and villous blunting and lymphocytes infiltration in the lamina propria.[14]
- HIV-associated alterations in mucosal immunity may predispose those with HIV to enteric bacterial infections.[7]
- Risk factors that contribute to HIV acquisition may increase risk of exposure to sexually transmitted infections that may manifest as enteritis or proctitis.[1]
- Advanced HIV/AIDS broadens the number of etiologic agents to include opportunistic infections that cause diarrhea.[13]
- Acute: Salmonella, Shigella, Campylobacter, Clostridium difficile, E. coli (enteroaggregative EAEC), S. aureus, Vibrio parahemolyticus, Yersinia, norovirus[9] and other viruses (calicivirus, astrovirus, adenovirus).
- Chronic: Cryptosporidium, microsporidia, MAC, CMV, Cyclospora, Giardia, Cystoisospora, Entamoeba histolytica, Strongyloides, HIV enteropathy, and the causes of acute diarrhea listed above, especially Salmonella.
- CD4 < 50: Cryptosporidium,microsporidia, CMV, MAC.
- Pathogen-negative, chronic, large-volume diarrhea: KS or lymphoma.
- Non-infectious causes: adverse drug reactions, inflammatory bowel disease, dietary (milk, sorbitol, caffeine), malabsorption, exocrine pancreatitic insufficiency, endocrine disease.
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Last updated: September 3, 2021
Citation
Spacek, Lisa A. "Diarrhea." Johns Hopkins HIV Guide, 2021. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545056/4/Diarrhea.
Spacek LA. Diarrhea. Johns Hopkins HIV Guide. 2021. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545056/4/Diarrhea. Accessed March 30, 2023.
Spacek, L. A. (2021). Diarrhea. In Johns Hopkins HIV Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545056/4/Diarrhea
Spacek LA. Diarrhea [Internet]. In: Johns Hopkins HIV Guide. ; 2021. [cited 2023 March 30]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545056/4/Diarrhea.
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