title: Inflammatory bowel disease in individuals seropositive for the human immunodeficiency virus.
abstract: OBJECTIVE
  CD4 lymphocytes mediate disease expression in both human immunodeficiency virus (HIV) infection and inflammatory bowel disease (IBD). Analysis of the clinical course of IBD in HIV-seropositive individuals may elucidate aspects of the role of CD4 lymphocytes in the pathogenesis of these conditions.
  
  
  METHODS
  A retrospective case series study.
  
  
  METHODS
  Diagnostic coding for IBD and pharmacy records for 5-aminosalicylic acid compounds and rectal steroid preparations were examined for all HIV-seropositive subjects attending the Chelsea and Westminster Hospitals between January 1988 and December 1993. Eight HIV-seropositive individuals with a confirmed diagnosis of IBD were identified.
  
  
  METHODS
  HIV/Genitourinary medicine (GUM) units.
  
  
  METHODS
  Change in CD4 count.
  
  
  RESULTS
  Four subjects with an intact colon had a decline in CD4 count of 85 cells/mm3/year, four patients undergoing colectomy had a subsequent rise of four cells/mm3/year and eight case matched controls had a decline of 47 cells/mm3/year. Acute exacerbations of IBD did not cause a significant change in CD4 count. There were no exacerbations of IBD in patients with a CD4 count below 200 cells/mm3.
  
  
  CONCLUSIONS
  HIV infection may influence the pathogenesis of IBD. A chronically inflamed colon may accelerate CD4 cell depletion which is reversed by colectomy.
authors.affiliation: Kobler Centre, Chelsea and Westminster Hospital, London, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Sharpstone
authors.forename: A
authors.initials: A
authors.lastname: Duggal
authors.forename: B G
authors.initials: BG
authors.lastname: Gazzard
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D006678:HIV / Q000276:immunology*; D006679:HIV Seropositivity / Q000150:complications / Q000276:immunology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology / Q000601:surgery; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies