A low prevalence of H pylori and endoscopic findings in HIV-positive Chinese patients with gastrointestinal symptoms.
OBJECTIVE
To compare the prevalence of H pylori infection, peptic ulcer, cytomegalovirus (CMV) infection and Candida esophagitis in human immunodeficiency virus (HIV)-positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections.


METHODS
A total of 151 patients (122 HIV-positive and 29 HIV-negative) with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of H pylori infection, CMV, candida esophagitis and histologic chronic gastritis.


RESULTS
The prevalence of H pylori was less common in HIV-positive patients (22.1%) than in HIV-negative controls (44.8%; P < 0.05), and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group, HIV-positive patients had a lower incidence of peptic ulcer (20.7% vs 4.1%; P < 0.01), but a higher prevalence of chronic atrophy gastritis (6.9% vs 24.6%; P < 0.05)ìCandida esophagitis and CMV infection. Unlike HIV-negative group, H pylori infection had a close relationship to chronic active gastritis (P < 0.05). In HIV-positive patients, chronic active gastritis was not significantly different between those with H pylori infection and those without.


CONCLUSIONS
The lower prevalence of H pylori infection and peptic ulcer in HIV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer. The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to H pylori infection.
Lv
Fu-Jing
FJ
Department of Digestive Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China.
Luo
Xiao-Lan
XL
Meng
Xin
X
Jin
Rui
R
Ding
Hui-Guo
HG
Zhang
Shu-Tian
ST
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D000328:Adult; D044466:Asian People; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D002681:China / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D020776:Endoscopes, Gastrointestinal; D004941:Esophagitis / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D015995:Prevalence