Serum pepsinogen and gastrin levels in HIV-positive patients: relationship with CD4+ cell count and Helicobacter pylori infection.
BACKGROUND
The relationship between serum parameters of gastric function and Helicobacter pylori infection in human immunodeficiency virus (HIV)-positive patients is almost unknown.


OBJECTIVE
To investigate in HIV-infected patients: (i) the relationship between serum gastrin and serum pepsinogens over the progressive phases of HIV-related disease; (ii) the impact of H. pylori infection on gastrin and pepsinogen serum levels and its relation to antral histology; (iii) the prevalence of parietal cell autoantibodies.


METHODS
Fifty-nine HIV-positive patients were studied by upper endoscopy plus gastric antral biopsy. Serum samples were tested for gastrin, pepsinogen A, pepsinogen C and parietal cell autoantibodies.


RESULTS
In patients without overt acquired immunodeficiency syndrome (AIDS), or with a CD4+ count of > 100 x 10(6) cells/L, mean serum levels of gastrin and pepsinogen C were higher than in subjects with AIDS or with a CD4+ count of < 100 x 10(6) cells/L (P < 0.01). Only one patient was found to be positive for parietal cell autoantibodies. H. pylori infection was associated with increased values of gastrin and pepsinogen C only in HIV-positive patients without AIDS or with a CD4+ count of > 100 x 10(6) cells/L. Atrophy was more frequent in patients with overt AIDS than in those without overt AIDS (57% vs. 33%, P=N.S.), and/or in patients with a CD4+ count of < 100 x 10(6) cells/L than in those with a CD4+ count of > 100 x 10(6) cells/L (62% vs. 26%, P < 0.05).


CONCLUSIONS
HIV-positive patients without overt AIDS have increased serum levels of gastrin and pepsinogen C compared with HIV-positive patients with overt AIDS.
Fabris
P
P
Department of Infectious Diseases and Tropical Medicine, S. Bortolo Hospital, Vicenza, Italy. pfabris@yahoo.com
Pilotto
A
A
Bozzola
L
L
Tositti
G
G
Soffiati
G
G
Manfrin
V
V
de Lalla
F
F
D017088:AIDS-Related Opportunistic Infections / Q000097:blood* / Q000150:complications / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000150:complications / Q000276:immunology; D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D018791:CD4 Lymphocyte Count; D005260:Female; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000097:blood / Q000209:etiology / Q000276:immunology; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications / Q000276:immunology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020115:Pepsinogen C / Q000097:blood*
D001323:Autoantibodies; D005755:Gastrins; D020115:Pepsinogen C