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Although diarrhea caused by opportunistic pathogens has been seen less frequently in HIV-infected patients since the advent of effective combination antiretroviral therapy (ART), noninfectious diarrhea remains a problem often caused by ART itself. If juggling antiretrovirals is not feasible and standard antidiarrheals fail, clinicians may be left without treatment alternatives.
In a manufacturer-supported, randomized, phase III study, researchers evaluated the efficacy of crofelemer, a plant-derived chloride ion channel inhibitor with minimal oral absorption. Participants (N=376) were almost all on effective combination ART (64% on protease inhibitors), with diarrhea generally of years' duration and common infectious etiologies excluded. The…