L-glutamine supplementation improves nelfinavir-associated diarrhea in HIV-infected individuals

HIV Clin Trials. 2003 Sep-Oct;4(5):324-9. doi: 10.1310/BFDT-J2GH-27L7-905G.


Purpose: To determine whether L-glutamine decreases the severity of nelfinavir-associated diarrhea in HIV-infected individuals. Other endpoints include the effect on quality of life, muscle-wasting syndrome, CD4 counts, and viral load.

Method: HIV-infected patients with nelfinavir-associated diarrhea for >1 month were randomized to receive L-glutamine 30 g/day or placebo for 10 days in a prospective, double-blind, crossover study. Diarrhea was measured on a scale ranging from grade 0 (no diarrhea) to grade 4 (severe diarrhea, > 7 stools/day). Quality of life was assessed by the Medical Outcome Study (MOS) HIV questionnaire.

Results: Twenty-five participants completed the study. There was a significant difference between the L-glutamine and placebo arms on the mean grade of diarrhea (0.762 vs. 1.850, p <.01) when placebo was administered first. When L-glutamine was administered first, there was a significant crossover effect (p <.02), with similar mean grades of diarrhea in the two groups. There was also a significant difference between L-glutamine and placebo in the mean change in MOS scores from baseline (1.48 vs. -2.19, p <.017). There were no significant differences between treatment groups for the other endpoints.

Conclusions: In this population of HIV-positive participants, L-glutamine 30 g/day significantly (p <.01) reduced the severity of nelfinavir-associated diarrhea and produced improved quality of life compared with placebo.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Cross-Over Studies
  • Diarrhea / chemically induced*
  • Diarrhea / pathology
  • Diarrhea / prevention & control*
  • Double-Blind Method
  • Female
  • Glutamine / administration & dosage*
  • HIV Infections / drug therapy*
  • HIV Protease Inhibitors / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Nelfinavir / adverse effects*
  • Prospective Studies
  • Quality of Life
  • Severity of Illness Index
  • Treatment Outcome
  • Viral Load


  • HIV Protease Inhibitors
  • Glutamine
  • Nelfinavir