Helicobacter pylori status, endoscopic findings, and serology in HIV-1-positive patients
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We have carried out a large prospective study of the frequency ofH. pylori infection and HIV-1 status in a community of ex-drug abusers including subjects with (N=210) and without (N=259) upper gastrointestinal symptoms, endoscopy and serology. Control groups were patients with upper gastrointestinal symptoms not at high risk of HIV-1 infection (N=219) and asymptomatic blood donors (n=322).H. pylori was present in 52% of symptomatic community resident having endoscopy and 55% of the control patients with symptoms but not at high risk of HIV-1 infection.H. pylori was less common in HIV-1-positive patients (40%) than those who were negative (66%;P<0.001). In patients with AIDS (33%), the frequency ofH. pylori infection was reduced compared to HIV-1-positive patients without AIDS (53%;P=0.05). All the residents with AIDS had upper gastrointestinal symptoms. In community residents, peptic ulcer was always associated withH. pylori infection. ByH. pylori serology, there was no difference in the frequency of infection in asymptomatic residents (56%) whether HIV-1 positive (55%) or HIV-1 negative (58%) compared with those residents with symptoms. Overall,H. pylori was less common in HIV-1-positive residents (49%) than those who were HIV-1 negative (61%;P<0.05). This difference was due mainly to the low frequency of infection in residents with AIDS (33%).H. pylori infection is common in HIV-1 positive patients, and only slightly reduced when compared with at-risk HIV-1-negative subjects. Peptic ulcer is associated withH. pylori in HIV-1 infection. Serology is a reliable marker ofH. pylori infection in HIV-1-positive patients, including those with advanced disease.
Key WordsHelicobacter pylori HIV 1 AIDS peptic ulcer dyspepsia
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- 1.Francis ND, Logan RPH, Walker MM, Polson RJ, Boylstan AW, Pinching AJ, Harris JRW, Baron JH: Campylobacter pylori in the upper gastrointestinal tract of patients with HIV-1 infection. J Clin Pathol 43:60–62, 1990Google Scholar
- 2.Edwards PD, Carrick J, Lee A, Mitchell H, Copper D, Turner J:Campylobacter pylori: Not the major cause of histological gastritis in AIDS. Gastroenterology 94:135, 1989Google Scholar
- 3.Logan RPH, Polson RJ, Rao G, Walker MM, Pedley S, Harris JRQ, Pinching AJ, Baron JH.Helicobacter pylori and HIV infection. Lancet 1:1456, 1990Google Scholar
- 4.Lim SG, Lipman MCI, Squire S, Pillay D, Gillespie S, San Key EA, Dhillon AP, Johnson MA, Lu CA, Pomider RE: Audit on endoscopic surveillance biopsy specimens in HIV positive patients with gastrointestinal symptoms. Gut 34:1429–1432, 1993Google Scholar
- 5.Aceti A, Celestino D, Pennica A, Leri O, Caferro M: Antibodies to Helicobacter pylori in HIV-1 infection. Lancet 1:571, 1990Google Scholar
- 6.MMWR: CDC revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 36:1–15, 1987Google Scholar
- 7.Vaira D, Holton J, Osborn J, D'Anna L, Romanos A, Falzon M, McNeil I: Endoscopy in dyspeptic patients: Is gastric mucosal biopsy useful? Am J Gastroenterol 85:701–704, 1990Google Scholar
- 8.Whitehead R: Mucosal biopsy of the gastrointestinal tract.In Major Problems in Pathology, Vol. 3 JL Bennington (ed). Philadelphia, WB Saunders, 1985, pp 47–58Google Scholar
- 9.Vaira D, Miglioli M, Mulè P, Holton J, Menegatti M, Vergura M, Biasco G, Conte R, Logan RPH, Barbara L: Prevalence of peptic ulcer inHelicobacter pylori positive blood donors. Gut 35:309–312, 1994Google Scholar
- 10.Oderda G, Vaira D, Holton J, Ainley C, Altare F, Boero M, Smith A, Ansaldi N:Helicobacter pylori in children with peptic ulcer and their families. Dig Dis Sci 36:572–576, 1991Google Scholar
- 11.Aceti A, Attanasio R, Pennica A, Taliani G, Sebastiani A, Rerra G, Ippolito G, Perucci CA:Campylobacter pylori infection in homosexuals. Lancet 2:154–155, 1987Google Scholar