title: Association of gastric hypoacidity with opportunistic enteric infections in patients with AIDS.
abstract: To determine the relation and possible significance of gastric hypoaciditity to chronic diarrhea in AIDS, patients with and without chronic (greater than 1 month) diarrhea underwent fasting gastric juice pH measurement and microbiologic study and upper and lower endoscopy with biopsy. All 8 patients with diarrhea and high gastric pH (greater than 3; mean, 6.1 +/- 1.0) had gastric bacterial overgrowth (greater than 10(4) bacteria/mL) along with opportunistic enteropathogens in the duodenum or rectosigmoid, but only 1 of 6 patients with diarrhea and gastric pH in the normal range (less than or equal to 3; mean, 1.9 +/- 0.7) had overgrowth or an opportunistic enteropathogen. By contrast, all but 1 of 9 controls (AIDS patients without diarrhea) had normal fasting gastric pH (mean, 2.9 +/- 1.5). Overall, the presence of gastric hypoacidity was associated with identification of opportunistic enteropathogens (P = .035). Thus, gastric hypoacidity is associated with quantitative bacterial overgrowth and opportunistic enteric infections and may be etiologically important in the pathophysiology of the chronic diarrhea seen in some AIDS patients.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: P C
authors.initials: PC
authors.lastname: Belitsos
authors.forename: J K
authors.initials: JK
authors.lastname: Greenson
authors.forename: J H
authors.initials: JH
authors.lastname: Yardley
authors.forename: J R
authors.initials: JR
authors.lastname: Sisler
authors.forename: J G
authors.initials: JG
authors.lastname: Bartlett
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000150:complications*; D002908:Chronic Disease; D003967:Diarrhea / Q000150:complications*; D004386:Duodenum / Q000382:microbiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications*; D013270:Stomach / Q000382:microbiology / Q000473:pathology