title: Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study.
abstract: To determine the aetiology of persistent diarrhoea in African patients with acquired immunodeficiency syndrome (AIDS), 42 patients with human immunodeficiency virus (HIV) and persistent diarrhoea were enrolled in a microbiological, endoscopic, and histological study. Cryptosporidium was the intestinal parasite most often identified (30%); Isospora belli was found in 12% of the patients. Histological examination of the duodenal mucosa showed a non-specific inflammatory reaction in a significantly higher number of HIV-seropositive patients (82%) than HIV-seronegative controls without diarrhoea (52%) (p = 0.02). Lymphocytes were more likely to be found in inflammatory reactions in HIV-seropositive patients than in controls (p less than 0.0001). Pathogens were observed in histological sections of the duodenum of HIV-seropositive patients only (p = 0.002) and included cryptosporidia (four patients) Isospora belli (one), Strongyloides stercoralis (one), and Cryptococcus neoformans (one). On histological examination the rectal mucosa of HIV-seropositive patients and controls was similar, except eosinophils were more likely to be present in inflammatory reaction in HIV-seropositive patients (p = 0.05) and enteric pathogens were observed only in HIV-seropositive patients (cytomegalovirus inclusion bodies (one) and Schistosoma mansoni (two). The aetiology of persistent diarrhoea in most African AIDS patients remains unclear.
authors.affiliation: Projet SIDA, Department of Public Health, Kinshasa, Zaire.
authors.forename: R
authors.initials: R
authors.lastname: Colebunders
authors.forename: K
authors.initials: K
authors.lastname: Lusakumuni
authors.forename: A M
authors.initials: AM
authors.lastname: Nelson
authors.forename: P
authors.initials: P
authors.lastname: Gigase
authors.forename: I
authors.initials: I
authors.lastname: Lebughe
authors.forename: E
authors.initials: E
authors.lastname: van Marck
authors.forename: B
authors.initials: B
authors.lastname: Kapita
authors.forename: H
authors.initials: H
authors.lastname: Francis
authors.forename: J J
authors.initials: JJ
authors.lastname: Salaun
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D015023:Democratic Republic of the Congo; D003967:Diarrhea / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology / Q000473:pathology; D004724:Endoscopy; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications* / Q000469:parasitology / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male