Intestinal inflammation, ileal structure and function in HIV.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Intestinal inflammation, ileal structure and function in HIV.

AIDS. 1996 Oct;10(12):1385-91. Unique Identifier : AIDSLINE MED/97057729
Bjarnason I; Sharpstone DR; Francis N; Marker A; Taylor C; Barrett M; Macpherson A; Baldwin C; Menzies IS; Crane RC; Smith T; Pozniak A; Gazzard BG; Department of Clinical Biochemistry, King's College School of Medicine; and Dentistry, London, UK.

Abstract: OBJECTIVES: This study examines small intestinal absorption-permeability, intestinal inflammation and ileal structure and function in HIV-positive male homosexuals. METHODS: Thirty HIV-seropositive male homosexuals at various stages of disease underwent intestinal absorption permeability and 111indium leukocyte studies (for quantification of intestinal inflammation). Twenty-six men with AIDS had a dual radioisotopic ileal function test (whole body retention of tauro 23-[75Se]-selena 25-homocholic acid and 58cobalt-labelled cyanocobalamine), and 17 underwent ileocolonoscopy with terminal ileal biopsy. RESULTS: Well, HIV-infected, subjects had normal intestinal absorption-permeability, but both functions were impaired upon the development of AIDS. The median faecal excretion of 111indium in well patients (0.66%) did not differ significantly (P > 0.5) from controls (0.46%), but subjects with AIDS who were well or who had diarrhoea had significant (P < 0.005) intestinal inflammation (1.33% and 2.18%, respectively). The median 7-day retention of tauro 23-[75Se]-selena 25-homocholic acid in well patients with AIDS (38.9%) did not differ significantly (P > 0.2) from controls (39.3%), whereas the absorption of 58cobalt-labelled cyanocobalamine was significantly P < 0.05) lower than controls (32.1% and 59.4%). Patients with AIDS-diarrhoea had significant (P < 0.001) malabsorption of both the bile acid (7.7%) and vitamin B12 (8.9%) which was more severe than in Crohn's ileitis (14.2% and 30.3%, respectively). Morphometric analyses of ileal biopsies were unremarkable in AIDS. CONCLUSIONS: These studies demonstrate a low-grade enteropathy in patients with AIDS, severe ileal malabsorption in patients with AIDS diarrhoea and relatively minor ileal morphologic changes. Malabsorption of bile acids may play a pathogenic role in patients with AIDS and diarrhoea.

Keywords: *Acquired Immunodeficiency Syndrome/PATHOLOGY *HIV Seropositivity/PATHOLOGY *Ileum/PATHOLOGY *Inflammatory Bowel Diseases/PATHOLOGY *Intestinal Absorption
970530
M9751976

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