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AIDS: Pancreatic Enzyme Supplements Might Counter Nutrient Malabsorption

Pancreatic enzyme supplements might reduce faecal fat loss in human immunodeficiency virus (HIV)-positive patients experiencing nutrient malabsorption.

Nutrient malabsorption undermines prognosis among people with AIDS. As pancreatic insufficiency seems to contribute to malabsorption, researchers from the University Hospital of Palermo and other Italian centres assessed the efficacy of oral pancreatic enzyme supplements in 24 HIV-positive patients with fat malabsorption.

During the open label, pilot study, researchers used steatocrits to assess faecal fat loss at entry and after two weeks during which patients did not receive pancreatic enzymes. They repeated steatocrits after patients had taken pancreatic extracts 1000 units of lipase per gram of ingested fat for two weeks.

All patients showed raised faecal fat loss at baseline and following the two weeks without supplementation. Faecal concentrations of elastase-1, chymotrypsin or both were abnormally low in six patients at entry. Five patients developed abdominal pain and were unable to tolerate the supplements.

In the remainder of patients, faecal fat loss declined after two week?s supplementation compared to baseline. In eight of the 19 patients who completed the two weeks of supplementation, steatocrit values were within normal limits.

Steatocrit values at entry correlated with the Centers for Disease Control (CDC) HIV classification. Moreover, the decrease in faecal fat loss following supplementation also correlated positively with CDC class.

The authors conclude that pancreatic enzyme supplements seem to be highly effective for reducing faecal fat loss in HIV-positive patients experiencing nutrient malabsorption. However, the authors add, double-blind studies are needed to confirm the results of this study.

Alimentary Pharmacology & Therapeutics 2001;15:1619-1625 "Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV-infected patients"

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