Percutaneous endoscopic gastrostomy in AIDS and control patients: risks and outcome.
OBJECTIVE
Wasting is a major feature of advanced HIV infection. Enteral nutrition via percutaneous endoscopic gastrostomy (PEG) is a safe and efficient therapy in malnutrition, but limited experience exists in wasted HIV patients. Here we report on outcome and risk of PEG-feeding in HIV patients compared with HIV-seronegative patients and with HIV patients without PEG.


METHODS
In 47 HIV-infected patients, PEG was placed because of wasting (n = 33), neurologic deficits (n = 11), or dysphagia (n = 3). Clinical, immunological, and nutritional data were compared with those of i) 15 HIV patients who refused PEG placement despite an appropriate indication, ii) 76 HIV patients without signs of malnutrition, and iii) 43 miscellaneous PEG patients.


RESULTS
PEG was as safe in HIV-infected as in HIV-seronegative patients. PEG feeding resulted in significant increases of body weight (+3.3 +/- 3.6 kg, p < 0.001), serum albumin concentration (+4.5 +/- 7.2 g/L, p < 0.005), and total iron-binding capacity (+9.5 +/- 11.5 mumol/L, p < 0.001). Moreover, our data indicate that PEG feeding may improve survival in wasted AIDS patients.


CONCLUSIONS
PEG feeding is safe and effective in the treatment of the AIDS wasting syndrome. Further prospective investigations are necessary to answer the question of whether treatment of wasting improves patient survival.
Ockenga
J
J
Abteilung Klinische Immunologie, Medizinische Hochschule Hannover, Germany.
Süttmann
U
U
Selberg
O
O
Schlesinger
A
A
Meier
P N
PN
Gebel
M
M
Schedel
I
I
Deicher
H
H
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality / Q000628:therapy*; D000328:Adult; D016022:Case-Control Studies; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006699:Home Care Services; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects; D008297:Male; D009748:Nutrition Disorders / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome