Diarrhoea, HIV-Associated
Description Medicine Treatment Referral B20.8 + (A07.2-3) DESCRIPTION Diarrhoea that persists for > 2 weeks. Often associated with wasting. Diarrhoea persisting for 4 weeks is a WHO stage 3 condition (if there is weight loss or fever it is stage 4). Send stool sample to look for ova, cysts and parasites in all cases. Note: A negative stool specimen does not exclude Cryptosporidium . If Cryptos
B20.8 + (A07.2-3)
DESCRIPTION
Diarrhoea that persists for > 2 weeks.
Often associated with wasting.
Diarrhoea persisting for 4 weeks is a WHO stage 3 condition (if there is weight loss or fever it is stage 4).
Send stool sample to look for ova, cysts and parasites in all cases.
Note:
A negative stool specimen does not exclude Cryptosporidium. If Cryptosporidium infection is suspected, request specific laboratory testing for the parasite.
MEDICINE TREATMENT
If stool is negative for parasites or shows Cryptosporidium:
- Loperamide, oral, 2 mg as required.
- Maximum 8 mg daily.
- Commence ART.
If stool shows Isospora belli:
- Cotrimoxazole, oral, 320/1600 mg (4 single strength (80/400 mg) tablets) 12 hourly for 10 days
- Followed by 160/800 mg (2 single strength (80/400 mg tablets) daily until CD4 > 200 cells/mm3 on ART.
- Commence ART.
REFERRAL
Stool contains blood or mucus.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare_V1.0_26 February 2026
Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV AND AIDS)_11.3 Opportunistic Infections, Treatment in Adult_11.3.5 Diarrhoea, HIV-Associated