triolein and Acquired-Immunodeficiency-Syndrome

To investigate the effect of small intestinal disease (SID) on the absorption of zidovudine (ZDV) in patients with AIDS.. Fourteen fasted homosexual men with AIDS received a single oral dose of ZDV (5 mg/kg). Nine subjects had clinical evidence of intestinal disease (chronic diarrhoea with wasting) confirmed by reduced fat absorption measured indirectly using the 14C-triolein test. Five subjects had AIDS-related symptoms other than those affecting the gastrointestinal tract with normal fat absorption. Sequential measurements of plasma ZDV including its glucuronide metabolite (GZDV) were obtained using radio-immunoassay and ZDV/GZDV concentrations-time profiles of both groups of subjects were compared. Comparisons were also made for each of the following computed variables: the maximum plasma concentration (Cmax), time to reach Cmax (Tmax), area under the plasma concentration-time curve (AUC0-6 h), the elimination half-life (t 1/2), and apparent oral clearance (CL0).. In patients with SID, Cmax ZDV was reduced (6.39 +/- 3.39 versus 11.51 +/- 5.01 mumol/l; P < 0.05) and Tmax ZDV prolonged (0.81 +/- 0.51 versus 0.40 +/- 0.14 h; P < 0.05) but AUC0-6 h ZDV was no different from the non-SID group (8.03 +/- 2.73 versus 14.56 +/- 9.0 mumol/l-1xh; P = 0.06). There were no differences in t 1/2 ZDV (1.22 +/- 0.20 versus 1.13 +/- 0.30 h) or CL0 ZDV (3017 +/- 1158 versus 1700 +/- 889 ml/min; P > 0.05) between SID and non-SID groups, respectively, and GZDV values were comparable between the two groups.. These data suggest delayed absorption rather than altered metabolism of ZDV in AIDS-related SID and raise the possibility of drug malabsorption. The clinical efficacy of orally administered low-dose ZDV regimens may require further evaluation in patients with chronic diarrhoea and AIDS.

Topics: Acquired Immunodeficiency Syndrome; Adult; Chronic Disease; Diarrhea; Humans; Intestine, Small; Male; Middle Aged; Triolein; Zidovudine

Malnutrition in patients with acquired immune deficiency syndrome (AIDS) is common and multifactorial. The possible causes of malnutrition were evaluated by performing studies of energy balance in five clinically stable outpatients with AIDS, six seronegative homosexual control subjects, and five seronegative heterosexual control subjects. The AIDS group was significantly depleted of body cell mass compared with the control subjects but the values did not change significantly over 6 wk. Food intake was normal in the AIDS group whereas intestinal absorptions of the pentose sugar xylose and of the triglyceride triolein were both significantly diminished. The AIDS patients were hypometabolic as compared with the control subjects and with predictions of metabolic rate based on the Harris-Benedict equation. We conclude that short-term energy balance can be maintained in clinically stable patients with AIDS. Hypometabolism is an appropriate metabolic response to the combination of body-cell-mass depletion and nutrient malabsorption.

Topics: Acquired Immunodeficiency Syndrome; Adult; Basal Metabolism; Body Composition; Body Mass Index; Eating; Energy Metabolism; Humans; Intestinal Absorption; Malabsorption Syndromes; Male; Nutrition Disorders; Potassium; Prospective Studies; Triolein; Xylose

Topics: Acquired Immunodeficiency Syndrome; Celiac Disease; Clinical Laboratory Techniques; Feces; Iodine Isotopes; Lipid Metabolism; Steatorrhea; Triolein