Exocrine pancreatic function and fat malabsorption in human immunodeficiency virus-infected patients.
BACKGROUND
Nutrients malabsorption frequently occurs in human immunodeficiency virus (HIV)-infected patients, but very few studies have investigated exocrine pancreatic digestive capacity in these patients. We therefore evaluated the frequency of exocrine pancreatic impairment and its eventual relation with fat malabsorption in HIV-infected patients.


METHODS
Thirty-five HIV-infected patients (30 male, 5 female: mean age +/- standard deviation, 33.6 +/- 7.2 years) and 51 sex- and age-matched controls without gastroenterologic diseases were studied. In all subjects fecal elastase 1 (EL-1) was assayed, and fecal fat excretion was evaluated with the steatocrit test.


RESULTS
Nineteen of 35 (54%) HIV-infected patients showed subnormal EL-1 values, whereas all the controls had normal values; furthermore, EL-1 values were significantly lower in patients than in controls: mean (95% confidence intervals), 207 ( 164-251 ) microg/g versus 312 (291-332) microg/g (P < 0.0001). Increased fecal fat excretion was observed in almost all (25 of 35) HIV-infected patients, and an inverse but not significant correlation was found between fecal EL-1 and steatocrit values. No association was found between reduced fecal EL-1 and the severity of HIV disease or nutritional and immunologic status. Opportunistic infections and drug administration had no influence on EL-1 concentrations in stools.


CONCLUSIONS
Reduced exopancreatic function is frequent in HIV-infected patients but does not seem to be a major factor contributing to fat malabsorption.
Carroccio
A
A
Dept. of Internal Medicine, University of Palermo, Ospedale Guadagna of Palermo, Italy.
Di Prima
L
L
Di Grigoli
C
C
Soresi
M
M
Farinella
E
E
Di Martino
D
D
Guarino
A
A
Notarbartolo
A
A
Montalto
G
G
D000328:Adult; D005223:Fats / Q000032:analysis; D005243:Feces / Q000737:chemistry; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008286:Malabsorption Syndromes / Q000503:physiopathology*; D008297:Male; D010179:Pancreas / Q000503:physiopathology*; D010196:Pancreatic Elastase / Q000032:analysis; D010186:Pancreatic Function Tests; D018709:Statistics, Nonparametric
D005223:Fats; D010196:Pancreatic Elastase