Intestinal mucosal inflammation associated with human immunodeficiency virus infection.
The role of the human immunodeficiency virus type-1 (HIV) in producing intestinal disease was studied prospectively in 74 HIV-infected individuals with (43) or without (31) the acquired immunodeficiency syndrome (AIDS). Thirty-one subjects had enteric infections; all but one had AIDS. Alteration in bowel habits was the most common symptom and occurred independently of enteric infections. Abnormal histopathology was present in 69% of cases, and the finding was associated with altered bowel habits. An HIV-associated protein, p24, was detected in 71% of biopsies by ELISA assay. Tissue p24 contents varied with disease stage and were highest in HIV-infected individuals without AIDS (Walter Reed classes 3 and 4). Tissue p24 detection was associated with both altered bowel habits and histologic mucosal abnormalities. Tissue contents of the cytokines, tumor necrosis factor-alpha and interleukin-1 beta, were higher in HIV-infected individuals than in controls and their elevations were independent of enteric infection. We conclude that HIV reactivation in the intestinal mucosa may be associated with an inflammatory bowel syndrome in the absence of other enteric pathogens.
Department of Medicine, St. Luke's-Roosevelt Hospital Center, New York, New York 10025.
D P
DP
Kotler
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S
Reka
F
F
Clayton
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D000704:Analysis of Variance; D001706:Biopsy; D016009:Chi-Square Distribution; D003106:Colon / Q000737:chemistry / Q000382:microbiology / Q000473:pathology; D016207:Cytokines / Q000032:analysis; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D015497:HIV-1; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D007413:Intestinal Mucosa / Q000737:chemistry / Q000382:microbiology / Q000473:pathology*; D008297:Male; D011446:Prospective Studies
D016207:Cytokines; D016655:HIV Core Protein p24