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Albendazole chemotherapy for treatment of diarrhoea in patients with AIDS in Zambia: a randomised double blind controlled trial

, : Albendazole chemotherapy for treatment of diarrhoea in patients with AIDS in Zambia: a randomised double blind controlled trial. Bmj 312(7040): 1187-1191

A randomized double blind placebo controlled trial was conducted in Zambia at the home care service of the University Teaching Hospital in Lusaka, the Ndola Central Hospital in the north, and the Kara HIV Counselling and Testing Project in central Lusaka to determine the extent albendazole can treat or suppress diarrhea in AIDS patients. The trial also aimed to identify a chemotherapeutic agent that could achieve diarrhea treatment or suppression and be administered in the community without prior investigation. Clinical researchers randomly allocated 174 HIV-positive patients with persistent diarrhea (i.e., loose but not bloody stools at least 3 times/day) to the group that received 800 mg albendazole twice daily for 2 weeks or the placebo group. They followed the patients for 6 months. The albendazole group had diarrhea less often than the placebo group for the entire 6 month period. The difference was significant at all time points (p 0.025) except at 5-8 weeks. At 3-4 weeks post-treatment, the reduction in diarrhea was significant among patients at the Kara Trust (31% reduction; p = 0.004) and in Ndola (41% reduction; p 0.0001) but not at the University Teaching Hospital (10% reduction). Two weeks after treatment, the albendazole group had diarrhea on 29% fewer days than the placebo group (p 0.0001). During the post-treatment weeks of 9-16, the albendazole group experienced diarrhea on 42% fewer days than the placebo group (p = 0.002). Throughout the entire 6-month period, patients in the albendazole group were more likely to achieve remission of diarrhea than the placebo group (e.g., 26% vs. 9%, p = 0.003). The proportion of patients who were in remission increased to 35% when the researchers excluded deaths and withdrawals from treatment. Patients who had a Karnofsky score (a measure of overall severity of illness at the time of entry into the study) of 50-70 benefitted the most from albendazole treatment for diarrhea. Albendazole had no significant effect on mortality. The researchers surmised that much of albendazole's effectiveness was due to its effect on microsporidia infections.


PMID: 8634560

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