HIV enteropathy: comparative morphometry of the jejunal mucosa of HIV infected patients resident in the United Kingdom and Uganda.
OBJECTIVE
To compare jejunal mucosal morphometry in HIV infected patients resident in London and Uganda.


METHODS
Twenty HIV positive patients from London and 16 from Uganda were studied, and compared with HIV negative control subjects from both sites.


METHODS
Stools and biopsy specimens were examined for enteropathogens. Surface area to volume (S:V) ratio was estimated morphometrically, mean crypt length of jejunal biopsy specimens was measured, and HIV infected cells detected immunohistochemically were quantified.


RESULTS
Enteric pathogens were detected in none of the London patients, and in three Ugandan patients. S:V ratio was lower, and mean crypt length higher, in the specimens of London patients than in normal subjects, but there was no difference in S:V ratio or mean crypt length between Ugandan patients and controls. A negative correlation was present between S:V ratio and mean crypt length in all biopsy specimens analysed. HIV infected cells were detected only in lamina propria.


CONCLUSIONS
Infection of cells in the lamina propria of the jejunum with HIV stimulates crypt cell proliferation, and a fall in villous surface area. The mucosal response to HIV is masked by other pathogens in the African environment.
Batman
P A
PA
Bradford Royal Infirmary, UK.
Kapembwa
M S
MS
Miller
A R
AR
Sedgwick
P M
PM
Lucas
S
S
Sewankambo
N K
NK
Serwadda
D
D
Pudney
J
J
Moody
A
A
Harris
J R
JR
Griffin
G E
GE
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001706:Biopsy; D016022:Case-Control Studies; D002452:Cell Count; D002455:Cell Division; D006678:HIV / Q000276:immunology; D019053:HIV Enteropathy / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D018451:Homosexuality, Male; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D007583:Jejunum / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D014329:Tropical Climate; D014454:Uganda; D006113:United Kingdom
D000914:Antibodies, Viral