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Disorders of the Small Bowel

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Part of the Clinical Gastroenterology book series (CG)

Abstract

Gastrointestinal manifestations in HIV-infected patients constitute a common cause of morbidity and mortality. Since the introduction of ART, the incidence of opportunistic infectious diarrhea has decreased significantly. Chronic diarrhea is frequently seen in patients with advanced disease, causing complications such as severe malnutrition, dehydration, predisposal to secondary infections, and in some cases can be life threatening (Wilcox and Saag, Gut 57:861–870, 2008; Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents [Internet]. [cited 2018 Dec 11]. Available from: https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-opportunistic-infection/328/bacterial-enteric, 2017). Differentiation between infectious and noninfectious causes is key to improve patient survival as well as quality of life. Besides diagnostic-guided treatment when appropriate, prompt institution of ART is recommended in a majority of cases (Bennett et al., Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, 2015; Oldfield, Rev Gastroenterol Disord 2(4):176–188, 2002).

Keywords

HIV Gastrointestinal Immunocompromised Infection Opportunistic Diarrhea 

References

  1. 1.
    Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 8th ed: Elsevier; 2015. [cited 2018 Dec 4].Google Scholar
  2. 2.
    Michalopoulos N, Triantafillopoulou K, Beretouli E, Laskou S, Papavramidis TS, Pliakos I, et al. Small bowel perforation due to CMV enteritis infection in an HIV-positive patient. BMC Res Notes [Internet]. 2013. [cited 2018 Dec 2];6(1):45.CrossRefGoogle Scholar
  3. 3.
    Robilotti E, Deresinski S, Pinsky B. Norovirus. Clin Microbiol Rev [Internet]. 2015. [cited 2018 Dec 4];28(1):134.CrossRefGoogle Scholar
  4. 4.
    Boaretto Teixeira Fernandes M, Nogueira Moisés Cardoso PA, Bassani Altoé L, Junqueira De Castro I, Almeida Rosa Da Silva G, De Araújo Eyer-Silva W, et al. Gastrointestinal CMV disease and tuberculosis in an AIDS patient: synergistic interaction between opportunistic coinfections. Case Rep Med [Internet]. 2018. [cited 2018 Dec 2]; 2018:8047892.Google Scholar
  5. 5.
    Debi U, Ravisankar V, Prasad KK, Sinha SK, Sharma AK. Abdominal tuberculosis of the gastrointestinal tract: revisited [Internet]. World J Gastroenterol. 2014. [cited 2018 Dec 2];20:14831–40.CrossRefGoogle Scholar
  6. 6.
    Shaw RD. Viral infections of the gastrointestinal tract. Curr Opin Gastroenterol [Internet]. 2000. [cited 2018 Dec 3];16(1):12–7.CrossRefGoogle Scholar
  7. 7.
    Wilhelmi I, Roman E, Sánchez-Fauquier A. Viruses causing gastroenteritis [Internet]. Clin Microbiol Infect. 2003 [cited 2018 Dec 3];9:247–62.CrossRefGoogle Scholar
  8. 8.
    Glover M, Tang Z, Sealock R, Jain S. Diarrhea as a presenting symptom of disseminated toxoplasmosis. Case Rep Gastrointest Med [Internet]. 2017. [cited 2018 Dec 3];2017:1–4.CrossRefGoogle Scholar
  9. 9.
    Aidsinfo. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. – June 18, 2008. 2008 [cited 2018 Dec 3];1–289. Available from: aidsinfo.nih.gov. https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescentarv/ 36/opportunistic.
  10. 10.
    Khanaliha K. Detection of emergence Cyclospora cayetanensis in HIV/AIDS patient with diarrhea from Tehran. Iran J Public Health [Internet]. 2015. [cited 2018 Dec 3];44(6):865–8.Google Scholar
  11. 11.
    Koch J, Kim L, Friedman S. Gastrointestinal manifestations of HIV. [Internet]. 1998. [cited 2018 Dec 4]. http://hivinsite.ucsf.edu/InSite? page=kb-04-01-11.
  12. 12.
    Vazquez Guillamet LJ, Saul Z, Miljkovic G, Vilchez GA, Mendonca N, Gourineni V, et al. Strongyloides stercoralis infection among human immunodeficiency virus (HIV)-infected patients in the United States of America: a case report and review of literature [Internet]. Am J Case Rep. 2017. [cited 2018 Dec 3];18:339–46.CrossRefGoogle Scholar
  13. 13.
    Wilhelmi I, Roman E, Sánchez-Fauquier A. Viruses causing gastroenteritis [Internet]. Clin Microbiol Infect. 2003. [cited 2018 Dec 3];9:247–62.CrossRefGoogle Scholar
  14. 14.
    Weisman IM, Moreno AJ, Parker AL, Sippo WC, Liles WJ. Gastrointestinal dissemination of coccidioidomycosis. Am J Gastroenterol [Internet]. 1986. [cited 2018 Dec 3];81(7):589–93.Google Scholar
  15. 15.
    Anderson BR, Marriott J, Bulathsinghala C, Anjum H, Surani S. Gastrointestinal histoplasmosis presenting as an acute abdomen with jejunal perforation. Case Rep Med [Internet]. 2018. [cited 2018 Dec 3];2018:4.  https://doi.org/10.1155/2018/8923972.CrossRefGoogle Scholar
  16. 16.
    Suh KN, Anekthananon T, Mariuz PR. Gastrointestinal histoplasmosis in patients with AIDS: case report and review. Clin Infect Dis [Internet]. 2001. [cited 2018 Dec 3];32(3):483–91.CrossRefGoogle Scholar
  17. 17.
    Jacobson MA, Aberg JA. Mycobacterium avium complex and atypical mycobacterial Infections in the setting of HIV infection [Internet]. University of California San Francisco; 2006. [cited 2018 Dec 3]. Available from: http://hivinsite.ucsf.edu/InSite?page=kb-05-01-05.
  18. 18.
    Echavarría M. Adenoviruses in immunocompromised hosts. Clin Microbiol Rev [Internet]. 2008. [cited 2018 Dec 3];21(4):704–15.CrossRefGoogle Scholar
  19. 19.
    Johnson TG, Rumbaugh KA, May AK. Clostridium difficile enteritis causing small bowel perforation in the absence of common risk factors. Surg Infect Case Reports [Internet]. 2016. [cited 2018 Dec 3];1(1):85–7. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L623722651%0Ahttp://dx.doi.org/10.1089/crsi.2016.0020.
  20. 20.
    McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Sammons JS, Sandora TJ, Wilcox MH. Clostridium difficile. Clin Infect Dis [Internet]. 2018. [cited 2018 Dec 3];66(7):1–48. Available from: https://www.idsociety.org/practice-guideline/clostridium-difficile/.
  21. 21.
    Imlay H, Kaul D, Rao K. Risk factors for Clostridium difficile infection in HIV-infected patients. SAGE Open Med [Internet]. 2016. [cited 2018 Dec 3];4:2050312116684295.Google Scholar
  22. 22.
    Ooi S, Lorber B. Gastroenteritis due to Listeria monocytogenes. Clin Infect Dis [Internet]. 2005. [cited 2018 Dec 3];40(9):1327–32.CrossRefGoogle Scholar
  23. 23.
    Norberg AN, Maure AE, Svaiter N, Goncalves AS, Sanchez FG. Listeria monocytogenes in HIV-infected patients in a hospital of Nova Iguacu, Rio de Janeiro, Brazil. J Venom Animals Toxins Incl Trop Dis [Internet]. 2005. [cited 2018 Dec 3];11(4):601.Google Scholar
  24. 24.
    McLaughlin JB, DePaola A, Bopp CA, Martinek KA. Outbreak of Vibrio parahaemolyticus gastroenteritis associated with Alaskan oysters. NEJM [Internet]. 2005. [cited 2018 Dec 3];353:1463–70.CrossRefGoogle Scholar
  25. 25.
    Koch J, Kim L, Friedman S. Gastrointestinal manifestations of HIV. [Internet]. 1998 [cited 2018 Dec 4]. Available from: http://www.hivinsite.ucsf.edu.
  26. 26.
    Balthazar EJ, Noordhoorn M, Megibow AJ, Gordon RB. CT of small-bowel lymphoma in immunocompetent patients and patients with AIDS:comparison of findings. AJR Am J Roentgenol. 1997;168(3):675.CrossRefGoogle Scholar
  27. 27.
    Viazis N, Vlachogiannakos J, Georgiou O, Rodias M, Georgiadis D, Papastamopoulos V, et al. Course of inflammatory bowel disease in patients infected with human immunodeficiency virus. Inflamm Bowel Dis [Internet]. 2010. [cited 2018 Dec 4];16(3):507–11.CrossRefGoogle Scholar
  28. 28.
    Adiga A, Panikkath D. A review of inflammatory bowel disease in patients with human immunodeficiency virus infection. J AIDS Clin Res [Internet]. 2016. [cited 2018 Dec 4];07(05):575.Google Scholar
  29. 29.
    Cello JP, Day LW. Idiopathic AIDS enteropathy and treatment of gastrointestinal opportunistic pathogens. Gastroenterology [Internet]. 2009. [cited 2018 Dec 4];136(6):1952–65.CrossRefGoogle Scholar
  30. 30.
    Verdier RI, Fitzgerald DW, Johnson WD, Pape JW. Trimethoprim-sulfamethoxazole compared with ciprofloxacin for treatment and prophylaxis of Isospora belli and Cyclospora cayetanensis infection in HIV-infected patients. A randomized, controlled trial. Ann Intern Med [Internet]. 2000. [cited 2018 Dec 4];132(11):885–8.CrossRefGoogle Scholar
  31. 31.
    Zar FA, El-bayoumi E, Yungbluth MM. Histologic proof of acalculous cholecystitis due to Cyclospora cayetanensis. Clin Infect Dis [Internet]. 2001. [cited 2018 Dec 4];33:140–1.CrossRefGoogle Scholar
  32. 32.
    Usó J, Tirado MD, Moreno R, Campos A. Vibrio fluvialis diarrhoea in an HIV infected patient. Enferm Infect Microbiol Clin [Internet]. 2010. [cited 2018 Dec 4];28(10):748–9.CrossRefGoogle Scholar
  33. 33.
    Gauthier S, Tremblay MJ. Cholera toxin inhibits HIV-1 replication in human colorectal epithelial HT-29 cells through adenylate cyclase activation. Antiviral Res [Internet]. 2010. [cited 2018 Dec 4];88(2):207–16.CrossRefGoogle Scholar
  34. 34.
    Carvalho EM, Da Fonseca Porto A. Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis [Internet]. Parasite Immunol. 2004. [cited 2018 Dec 4];26:487–97.CrossRefGoogle Scholar
  35. 35.
    Abubakar I, Aliyu SH, Arumugam C, Usman NK, Hunter PR. Treatment of cryptosporidiosis in immunocompromised individuals: Systematic review and meta-analysis [Internet]. Br J Clin Pharmacol. 2007. [cited 2018 Dec 4];63:387–93.CrossRefGoogle Scholar
  36. 36.
    Bok K, Green KY. INFECT – norovirus gastroenteritis in immunocompromised patients. N Engl J Med [Internet]. 2012. [cited 2018 Dec 4];367(22):2126–32.CrossRefGoogle Scholar
  37. 37.
    Lindesmith L, Moe C, Marionneau S, Ruvoen N, Jiang X, Lindblad L, et al. Human susceptibility and resistance to Norwalk virus infection. Nat Med [Internet]. 2003. [cited 2018 Dec 4];9(5):548–53. Available from: https://www.mendeley.com/reference-management/web-importer/#id_3.CrossRefGoogle Scholar
  38. 38.
    Hutson AM, Atmar RL, Graham DY, Estes MK. Norwalk virus infection and disease is associated with ABO histo–blood group type. J Infect Dis [Internet]. 2002. [cited 2018 Dec 4];185(9):1335–7.CrossRefGoogle Scholar
  39. 39.
    Tang YW, Meng S, Li H, Stratton CW, Koyamatsu T, Zheng X. PCR enhances acid-fast bacillus stain-based rapid detection of Mycobacterium tuberculosis [Internet]. J Clin Microbiol. 2004. [cited 2018 Dec 9];42:1849–50.CrossRefGoogle Scholar
  40. 40.
    Benson CA, Williams PL, Currier JS, Holland F, Mahon LF, MacGregor RR, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome. Clin Infect Dis [Internet]. 2003. [cited 2018 Dec 9];37(9):1234–43.CrossRefGoogle Scholar
  41. 41.
    Molina JM, Goguel J, Sarfati C, Michiels JF, Desportes-Livage I, Balkan S, et al. Trial of oral fumagillin for the treatment of intestinal microsporidiosis in patients with HIV infection. ANRS 054 Study Group. Agence Nationale de Recherche sur le SIDA. AIDS [Internet]. 2000. [cited 2018 Dec 9];14(10):1341–8.CrossRefGoogle Scholar
  42. 42.
    Sorvillo FJ, Lieb LE, Seidel J, Kerndt P, Turner J, Ash LR. Epidemiology of isosporiasis among persons with acquired immunodeficiency syndrome in Los Angeles County [Internet]. Am J Trop Med Hyg. 1995. [cited 2018 Dec 9];53:656–9.CrossRefGoogle Scholar
  43. 43.
    Oldfield EC. Evaluation of chronic diarrhea in patients with human immunodeficiency virus infection. Rev Gastroenterol Disord [Internet]. 2002. [cited 2018 Dec 10];2(4):176–88.Google Scholar
  44. 44.
    Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents [Internet]. 2017 [cited 2018 Dec 11]. Available from: https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-opportunistic-infection/328/bacterial-enteric.
  45. 45.
    Anglaret X, Chene G, Attia A, et al. Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d’Ivoire: a randomised trial. Cotrimo-CI Study Group. Lancet. 1999;353(9163):1463–8. Available at http://www.ncbi.nlm.nih.gov/pubmed/10232311.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Infectious DiseasesUniversity of Connecticut School of MedicineFarmingtonUSA
  2. 2.Division of Infectious DiseasesThe Hospital of Central ConnecticutNew BritainUSA

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