Profile of crofelemer for the symptomatic treatment of diarrhea in HIV-infected persons

Christina Leonard,¹ Poorvi Chordia,¹ Rodger D MacArthur<sup>1,2

1</sup>Department of Infectious Diseases, Wayne State University, Detroit, MI, USA; ²Newland Immunology Center of Excellence, Southfield, MI, USA

Abstract: Diarrhea due to noninfectious causes is a major problem in human immunodeficiency virus (HIV)-infected persons, and is frequently related to antiretroviral therapy and HIV-associated enteropathy. Crofelemer is a first-in-class antidiarrheal agent that is United States Food and Drug Administration approved for noninfectious diarrhea in persons with HIV on antiretroviral therapy. Crofelemer is derived from the blood-red sap of Croton lechleri, a South American plant whose latex is associated with various healing attributes. In fact, it has a unique effect on chloride channels in the gastrointestinal lumen, and leads to decreased efflux of sodium molecules and water, thereby decreasing the frequency of stools. Crofelemer – a plant-based compound, discovered and investigated as the result of the increased prevalence of ethnobotany – is a novel and effective agent with a good safety profile. It could potentially improve the quality of life for HIV-infected patients and hopefully, in turn, will improve antiretroviral therapy compliance.

Keywords: chloride channels, secretory diarrhea, botanical, sangre de grado, intra-luminal