Fecal microbiota tx feasible for recurrent C. difficile in HIV

(HealthDay)—For HIV-infected individuals with recurrent Clostridium difficile infection, fecal microbiota therapy is feasible, according to a letter published in the May 21 issue of the Annals of Internal Medicine.

Latesha Elopre, M.D., and Martin Rodriguez, M.D., from the University of Alabama at Birmingham, describe two cases of fecal microbiota therapy in HIV-infected individuals—a 48-year-old man with AIDS receiving highly-active antiretroviral therapy and a 48-year- old woman with type 2 diabetes mellitus and AIDS receiving highly-active antiretroviral therapy. The first patient presented with recurrent diarrhea for eight months secondary to C. difficile infection and consented to fecal microbiota therapy after five relapses. The second patient was hospitalized for recurrent C. difficile infection and consented to fecal therapy after repeated recurrences following discontinuation of vancomycin therapy.

The researchers found that the day after administration of the fecal samples the diarrhea and abdominal pain resolved for the first patient, and the diarrhea decreased for the second patient. During five years of follow-up, the first patient experienced no recurrences, while the second patient had no further recurrences during six weeks of follow-up.

"On the basis of our experience, we believe that fecal microbiota therapy should be considered in other HIV-infected patients who have recurrent episodes of C. difficile infection that do not respond to standard therapy," the authors write.

One author disclosed financial ties to Merck.

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