Original Articles

Digestive Diseases and Sciences

, Volume 38, Issue 6, pp 1119-1127

First online:

Intestinal mucosal inflammation associated with human immunodeficiency virus infection

  • Donald P. KotlerAffiliated withGastrointestinal Division, Department of Medicine, Department of Pathology, St. Luke's-Roosevelt Hospital CenterCotlege of Physicians and Surgeons, Columbia University
  • , Safak RekaAffiliated withGastrointestinal Division, Department of Medicine, Department of Pathology, St. Luke's-Roosevelt Hospital CenterCotlege of Physicians and Surgeons, Columbia University
  • , Frederic ClaytonAffiliated withGastrointestinal Division, Department of Medicine, Department of Pathology, St. Luke's-Roosevelt Hospital CenterCotlege of Physicians and Surgeons, Columbia University

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Abstract

The role of the human immunodeficiency virus type-1 (HIV) in producing intestinal disease was studied prospectively in 74 HIV-infected individuals with (43) or without (31) the acquired immunodeficiency syndrome (AIDS). Thirty-one subjects had enteric infections; all but one had AIDS. Alteration in bowell habits was the most common symptom and occurred independently of enteric infections. Abnormal histopathology was present in 69% of cases, and the finding was associated with altered bowel habits. An HIV-associated protein, p24, was detected in 71% of biopsies by ELISA assay. Tissue p24 contents varied with disease stage and were highest in HIV-infected individuals without AIDS (Walter Reed classes 3 and 4). Tissue p24 detection was associated with both altered bowel habits and histologic mucosal abnormalities. Tissue contents of the cytokines, tumor necrosis factor-α and interleukin-1β, were higher in HIV-infected individuals than in controls and their elevations were independent of enteric infection. We conclude that HIV reactivation in the intestinal mucosa may be associated with an inflammatory bowel syndrome in the absence of other enteric pathogens.

Key Words

human immunodeficiency virus AIDS inflammation colitis cytokines prostaglandins leukotrienes ELISA radioimmunoassay diarrhea