Exposing The Threat of HIV Diarrhea: How Common is It?

Rishabh Mehta
Medically reviewed by
Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
Dr. Akansha is a licensed Clinical Pharmacologist. She possesses remarkable knowledge in Pharmacovigilance, prescription analysis, drug information, and drug safety services. Additionally, she is a keen learner and an educator.

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hiv diarrhea

HIV, or Human Immunodeficiency Virus, is known to have no symptoms to mild flu-like symptoms, of which Diarrhea is a common one. 

Without treatment, it only grows severe and chronic over time. Therefore, not only HIV Diarrhea is common, but so is AIDS Diarrhea. 

According to a report by NCBI, 50 percent of AIDS patients in developed nations suffer from Diarrhea. 

It may seem like a harmless or temporary symptom, but it can increase the possibility of life-threatening conditions over time. 

To prevent, treat, and recover from it, getting adequate knowledge about it becomes essential. 

This article will present a complete guide to HIV Diarrhea, unveiling its causes, duration, and treatment, offering a better understanding of this issue. 

Does HIV cause Diarrhea

HIV and Diarrhea are closely related. 

Diarrhea is a common symptom that affects almost 100 percent of HIV-infected people in developing regions. 

Not only is the virus or infection responsible for Diarrhea, but several other factors contribute to the problem. 

That is why it is important to look for the cause and site of origin of Diarrhea to deal with it better. 

Diarrhea has two sites of origin, which are the colon and the small bowel. 

Colon-originated Diarrhea, or Colitis,  is associated with pus, blood, and small-volume stools. 

On the other hand, small bowel-related Diarrhea, or Enteritis, has large volume watery stools with dehydration and abdominal pain. 

Fact:
Over time, Opportunistic infection-related Diarrhea cases have reduced, and drug-induced or unexplained Diarrhea cases are on the rise among HIV patients. 

What causes HIV Diarrhea

The causes of HIV Diarrhea are extensive. Some of them are:

Bacteria

bacteriaSource: Porntep-Kawjun
Bacteria under microscope

Enteric bacteria like Shigella flexneri, Salmonella enteritidis, and Campylobacter jejuni are the most common causes of HIV Diarrhea.

Traces of these bacteria are also found in the stools. 

However, small bowel bacterial growth is not found in this case among AIDS or HIV-1-infected people.  

Virus

Several viruses are known to cause GI infection and Diarrhea. These are significantly observed in HIV-infected patients. 

Some of these are Astrovirus, Picobirnavirus, Cytomegalovirus (CMV), Small Round Structured Virus (SRSV), and Rotavirus. 

CMV is the most common virus related to Diarrhea. According to a report, CMV contributed to 18 percent of 155 persistent Diarrhea cases. 

Intestinal infections and responsible parasites

Certain parasites, besides viruses, can also cause intestinal infections, which are common in HIV patients. 

Encephalitozoon intestinalis and Enterocytozoon bieneusi are known as the two main infection-causing pathogens leading to Diarrhea in HIV patients. 

Recommended Article
Diarrhea is a common, but not the only symptom of HIV. To know about other HIV symptoms,Read Understanding HIV Symptoms: A Comprehensive Guide

Antiretrovirals

Antiretroviral Therapy is an efficient HIV treatment, but it can also cause Diarrhea. 

Many antiretrovirals, especially Protease Inhibitors, are associated with high Diarrhea risk. 

It has resulted in a lack of HIV treatment for people experiencing Diarrhea due to medications. 

HIV enteropathy

Sometimes, non-infectious diarrhea occurs when no intestinal infectious pathogen is present. 

Then, the HIV virus itself is considered the cause of Diarrhea. 

It is characterized as chronic Diarrhea, which lasts longer than a month. 

How long does HIV Diarrhea last

All the symptoms of HIV usually last for one to two weeks, but in some cases, it can last longer.

If untreated, HIV infection worsens along with its symptoms.

It is evident from the fact that once HIV progresses into AIDS, Diarrhea progresses to chronic Diarrhea lasting for over a week. 

Warning:
HIV-related Diarrhea is associated with mortality and morbidity. So, one must consult a doctor for HIV treatment and related symptoms immediately to avoid serious complications.

HIV and Diarrhea treatment

Woman suffering from DiarrheaSource: Kanchanachitkhamma
Woman suffering from diarrhea

The cases of HIV Diarrhea caused by infectious agents are treated by Antiretroviral Therapy (ART). 

However, the cases of Diarrhea related to opportunistic infections have already been reduced. 

Opportunistic infections, or OI, are the infections that target and are more severe in people with a weak immune system such as HIV-infected people. Fungi, bacteria, parasites, and viruses cause OI. Some examples are Tuberculosis, Salmonella infection, and Candidiasis.

Currently, non-infectious HIV Diarrhea poses a big challenge. 

Moreover, some Diarrhea cases are due to ART itself. 

So, three other classes of Antidiarrheal medications are used in non-infectious Diarrhea cases. They are:

  • Absorbents: They bind fluids, bacterial toxins, and other compounds in the intestines to improve stool consistency. Bismuth subsalicylate, Attapulgite, and Kaolin/Pectin are a few examples
  • Antimotility Agents: They work to improve fecal transit time, which eases water absorption and reduces electrolyte loss. Loperamide, Tincture of Opium, and Diphenoxylate/Atropine are a few such agents
  • Antisecretory Agents: These inhibit the flow of electrolytes and water into the Gastrointestinal tract. Octreotide, Racecadotril, and Crofelemer are some examples of Antisecretory Agents

Conclusion

HIV Diarrhea is both a symptom of HIV and a consequence of its medications, opportunistic infections, and pathogens. 

A wide range of agents like bacteria, viruses, and fungi contribute to HIV-related Diarrhea. 

However, with time and the use of Antiretroviral Therapy, Diarrhea cases caused by infectious agents have reduced, but non-infectious Diarrhea instances are on the rise. 

Sometimes, Antiretroviral Therapy is also associated with the risk of Diarrhea, which raises difficulty in HIV treatment. 

In such cases, it is advised to consult a  doctor for alternative treatment instead of stopping it. 

Certain medications like Crofelemer, Opium Tincture, and Kaolin/Pectin can also prove beneficial for controlling Diarrhea. 

With proper and timely care, treatment, and precautions, HIV Diarrhea and other symptoms can be controlled, and quality of life can be improved. 

Frequently Asked Questions

What does HIV Diarrhea feel like?

HIV Diarrhea is caused by numerous reasons. So, the characteristics of Diarrhea vary according to the cause and site of origin. It can be large-volume, watery stools with abdominal pain and dehydration or small-volume stools with pus, mucus, and blood. 

Is Diarrhea a symptom of HIV?

Yes, Diarrhea is a symptom of HIV, be it acute HIV infection or chronic stage. It can be caused by multiple reasons, like opportunistic infections, bacteria, and medications. It is also accompanied by other flu-like symptoms such as fever, sore throat, night sweats, rash, and chills. 

How soon does Diarrhea start with HIV?

HIV has multiple flu-like symptoms, which may or may not show up. These symptoms also include Diarrhea. For acute HIV symptoms, it takes about 2 to 6 weeks to develop symptoms. These can worsen over time if left untreated. So, Diarrhea may turn into chronic Diarrhea. 

How often do you have Diarrhea with HIV?

Diarrhea involves three or more defecations daily. It is the most common HIV symptom that may arise due to multiple reasons. About 100 percent of HIV-infected people in developing countries may end up with chronic Diarrhea. The situation is a little better in developed countries. 

Citations:
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