Lower Helicobacter pylori infection and peptic ulcer disease prevalence in patients with AIDS and suppressed CD4 counts
Cacciarelli, A.G.; Marano, B.J.; Gualtieri, N.M.; Zuretti, A.R.; Torres, R.A.; Starpoli, A.A.; Robilotti, J.G.
American Journal of Gastroenterology 91(9): 1783-1784
1996
ISSN/ISBN: 0002-9270 PMID: 8792698 Document Number: 466528
Objective: The prevalence of Helicobacter pylori (HP) has previously been reported to be lower in AIDS patients. This study evaluated the prevalence of HP and peptic ulcer disease in relation to absolute CD4 counts in HIV-seropositive patients with GI symptoms. Design: Seventy-two patients (48 HIV-positive and 24 HIV-negative) with GI symptoms were evaluated with upper endoscopy and antral gastric biopsy. Samples were prepared with Giemsa stain and reviewed by a single pathologist to determine status of HP infection. The patients were stratified on the basis of HIV status and CD4 count: group A, HIV-positive patients with a CD4 count greater than 200, group B, HIV-positive patients with CD4 counts less than 200, and group C, an HIV-negative control group. Results: The prevalence of HP infection in the three groups was as follows: group A 69% (11/16), group B 13% (4/32), and group C 63% (15/24). Peptic ulcer prevalence in group A was 19% (3/16), group B 3% (1/32), and group C 25% (6/24). Conclusions: The prevalence of HP in HIV-positive patients with a CD4 count less than 200 is significantly lower (p lt 0.001) than that found in HIV-negative patients. The number of peptic ulcers in the HIV-positive group with CD4 lt 200 was significantly less (p = 0.035) than that of the HIV-negative patients. These results suggest a role of CD4 cell and immune function in sustaining HP infection and HP-related peptic ulcer disease.