Diarrhées et infection à VIH

The development of Highly Active Antiretroviral Therapies and of protease inhibitors in particular has permitted in the last ten years to dramatically improve the viral replication in HIV infected patients but the incidence of side effects and of diarrhoea in particular remains high. In general practice, the occurrence of diarrhoea should systematically lead to eliminate an infectious ætiology of diarrhoea. Many studies have demonstrated that diarrhoea under protease inhibitors and nelfinavir in particular are of a low grade severity, occurring usually at the onset of therapy and are responsible for discontinuation of treatment in less than 2% of cases. The medium term follow up of patients cohorts demonstrates the lack of impact of diarrhoea on the antiretroviral efficacy of protease inhibitors. Nevertheless, coexisting diarrhoea is a factor of poor quality of life. This should lead to propose to patients several simple therapies, including dietetic rules, in order to limit the incidence of diarrhoea and to improve its consequences on the quality of life of patients.