Helicobacter pylori-associated gastritis is rare in AIDS: antibiotic effect or a consequence of immunodeficiency?
Helicobacter pylori is the principal cause of type B histologic gastritis. AIDS is associated with increased susceptibility to Gram-negative enteric infections. Using a retrospective study design, we have determined the prevalence of H. pylori-associated histologic gastritis (based on gastric histopathology) in 201 patients with AIDS. These data were compared with H. pylori prevalence rates (based on serology) from healthy HIV-negative, age-matched Australian controls (n = 785) and a cohort (n = 137) of HIV-negative, dyspeptic patients undergoing panendoscopy and antral biopsy, at a community endoscopy center. Twenty-five of 201 (12.5%) patients with AIDS had histologic gastritis and, of these, six (25%) had H. pylori. The 3% (six of 201) H. pylori prevalence rate in the AIDS patients was significantly less than age-matched HIV-negative controls (22%) p = 0.001 and endoscopy center controls (59%) p = 0.009. The explanation for this unexpectedly low prevalence of H. pylori is not possible from these data. It may be a consequence of antimicrobial therapy. Other potential explanations may include specific HIV-related host factors, including hypochlorhydria or an inadequate mucosal inflammatory response, which may impair successful colonization of H. pylori.
Edwards
P D
PD
Bruce Hall Department of Gastroenterology, St. Vincent's Hospital, Sydney, Australia.
Carrick
J
J
Turner
J
J
Lee
A
A
Mitchell
H
H
Cooper
D A
DA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D003586:Cytomegalovirus Infections / Q000209:etiology; D005756:Gastritis / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies