Faecal tumour necrosis factor-alpha in individuals with HIV-related diarrhoea. NLM AIDSLINE Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

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Faecal tumour necrosis factor-alpha in individuals with HIV-related diarrhoea.

AIDS. 1996 Aug;10(9):989-94. Unique Identifier : AIDSLINE MED/97006439
Sharpstone DR; Rowbottom AW; Nelson MR; Lepper MW; Gazzard BG; Department of HIV/Genitourinary Medicine, Chelsea and Westminster; Hospital, London, UK.

Abstract: OBJECTIVE: HIV-related gastrointestinal infection is associated with diarrhoea, weight loss, mucosal inflammation and increased intestinal permeability. As tumour necrosis factor (TNF)-alpha may mediate these features this cytokine was measured in the faeces of HIV-seropositive individuals with diarrhoea to assess its role in the pathogenesis of HIV-related gastrointestinal disease and the association with specific intestinal pathogens. DESIGN: Prospective study. METHODS: Two hundred and four HIV-seropositive individuals provided stool samples that were analysed for faecal TNF-alpha (FTNF-alpha) using a standard sandwich enzyme-linked immunosorbent assay. RESULTS: Stool from patients with bacterial, cytomegalovirus (CMV) and microsporidial diarrhoea had significantly elevated FTNF-alpha compared with those who had pathogen-negative diarrhoea (P < 0.05). FTNF-alpha was not raised in cryptosporidiosis, pathogen-negative or solid stool. In subjects with diarrhoea of more than 2 weeks duration and three stool samples negative for enteric pathogens, FTNF-alpha greater than 15 U/ml has a sensitivity of 88% and a specificity of 66% for the diagnosis of diarrhoea-related CMV enteritis. CONCLUSION: TNF-alpha production may have a role in the pathogenesis of bacterial, microsporidial and CMV-related diarrhoea in HIV-seropositive individuals. Thus, anti-TNF-alpha agents may have a therapeutic role in the management of these conditions. FTNF-alpha greater than 15 U/ml in apparently pathogen-negative diarrhoea may suggest endoscopic gastrointestinal biopsy to diagnose CMV enteritis.
Keywords: AIDS-Related Opportunistic Infections/*METABOLISM/PHYSIOPATHOLOGY Diarrhea/ETIOLOGY/*METABOLISM Feces Human HIV Infections/*COMPLICATIONS Prospective Studies Tumor Necrosis Factor/*ANALYSIS JOURNAL ARTICLEKWDaids-relatedopportunisticinfections/KWDmetabolism/physiopathologydiarrhea/etiology/KWDmetabolismfeceshumanhivinfections/KWDcomplicationsprospectivestudiestumornecrosisfactor/KWDanalysisjournalarticle
970330
M9731500

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