Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study
Colebunders, R.; Lusakumuni, K.; Nelson, A.M.; Gigase, P.; Lebughe, I.; van Marck, E.; Kapita, B.; Francis, H.; Salaun, J.J.; Quinn, T.C.
Gut 29(12): 1687-1691
1988
ISSN/ISBN: 0017-5749 PMID: 3220308 DOI: 10.1136/gut.29.12.1687Document Number: 363580
To determine the aetiology of persistent diarrhoea in African patients with acquired immunodeficiency syndrome (AIDS), 42 patients with human immunodeficieny virus (HIV) and persistent diarrhoea were enrolled in a microbiological, endoscopic, and histological study. Cryptosporidium was the intestinal parasite most often identified (30%); Isospora belli was found in 12% of the patients. Histological examination of the duodenal mucosa showed a non-specific inflammatory reaction in a significantly higher number of HIV-seropositive patients (82%) than HIV-seronegative controls without diarrhoea (52%) (p=0.02). Lymphocytes were more likely to be found in inflammatory reactions in HIV-seropositive patients than in controls (p < 0.0001). Pathogens were observed in histological sections of the duodenum of HIV-seropositive patients only (p=0.002) and included cryptosporidia (four patients) Isospora belli (one), Strongyloides stercoralis (one), and Cryptococcus neoformans (one). On histological examination the rectal mucosa of HIV-seropositive patients and controls was similar, except eosinphils were more likely to be present in inflammatory reaction in HIV-seropositive patients (p=0.05) and enteric pathogens were observed only in HIV-seropositive patients (cytomegalovirus inclusion bodies (one) and Schistosoma mansoni (two)). The aetiology of persistent diarrhoea in most African AIDS patients remains unclear.