title: Altered small-intestinal permeability associated with diarrhoea in human-immunodeficiency-virus-infected Caucasian and African subjects.
abstract: 1. Small-intestine integrity in Caucasian and African patients infected with human immunodeficiency virus was determined by measuring the permeation across the mucosa of two sugars, lactulose and mannitol. 2. The sugars were assayed by h.p.l.c. and pulsed amperometric detection in 6 h urine samples. Stool microscopy for enteropathogens was performed in all patients. 3. The ratio of lactulose to mannitol recovered in urine was increased in Caucasian and African patients with advanced human immunodeficiency virus infection. Asymptomatic human-immunodeficiency-virus-infected subjects had a normal lactulose/mannitol ratio. African patients with diarrhoea showed a twofold reduction in mannitol excretion. Such a change in mannitol absorption was not detected in Caucasian patients and occurred regardless of the presence of enteropathogens. 4. Altered small-intestinal permeability is associated with symptomatic diarrhoea in human immunodeficiency virus infection in both Caucasian and African patients.
authors.affiliation: Department of Cellular and Molecular Sciences, St George's Hospital Medical School, London.
authors.forename: M S
authors.initials: MS
authors.lastname: Kapembwa
authors.forename: S C
authors.initials: SC
authors.lastname: Fleming
authors.forename: N
authors.initials: N
authors.lastname: Sewankambo
authors.forename: D
authors.initials: D
authors.lastname: Serwadda
authors.forename: S
authors.initials: S
authors.lastname: Lucas
authors.forename: A
authors.initials: A
authors.lastname: Moody
authors.forename: G E
authors.initials: GE
authors.lastname: Griffin
mesh_terms: D000328:Adult; D000818:Animals; D044383:Black People; D003458:Cryptosporidium / Q000302:isolation & purification; D003967:Diarrhea / Q000209:etiology / Q000378:metabolism* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D015658:HIV Infections / Q000150:complications* / Q000208:ethnology* / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D007413:Intestinal Mucosa / Q000378:metabolism; D007421:Intestine, Small / Q000378:metabolism / Q000382:microbiology; D007792:Lactulose / Q000378:metabolism; D008297:Male; D008353:Mannitol / Q000378:metabolism; D008875:Middle Aged; D044465:White People
chemical_list: D008353:Mannitol; D007792:Lactulose