Definition
AIDS enteropathy is a syndrome in an HIV-positive individual characterized by chronic, well-established diarrhea (greater than 1 month in duration) without an identified infectious cause after thorough evaluation (Zeitz et al. 1998). As such, AIDS enteropathy is a diagnosis of exclusion and can only be made after other forms of diarrheal illness have been ruled out. Indeed, reported evidence suggests that HIV itself may be an indirect diarrheal pathogen because viral proteins have been found in the gut. In situ hybridization of biopsies specimens obtained from the rectum and duodenum revealed HIV-infected cells in both the base of the crypts and within the lamina propria in up to 40% of patients; but while the virus was confined to lamina propria macrophages and enterochromaffin cells, it was found in epithelial cells (Nelson et al. 1988). Intestinal HIV infection may also affect local humoral immunity (with presence of high levels of interleukins IL-6, IL-10 and interferon...
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References and Further Reading
Cello, J. P., & Day, L. W. (2009). Idiopathic AIDS enteropathy and treatment of gastrointestinal opportunistic pathogens (Vol.136, p. 1952, 2009). Gastroenterology, 137, 393.
Kotler, D. P. (2005). HIV infection and the gastrointestinal tract. Aids, 19, 107–117.
Kotler, D. P., Scholes, J. V., & Tierney, A. R. (1987). Intestinal plasma-cell alterations in acquired-immunodeficiency-syndrome. Digestive Diseases and Sciences, 32, 129–138.
Nelson, J. A., Reynoldskohler, C., Margaretten, W., Wiley, C. A., Reese, C. E., & Levy, J. A. (1988). Human immunodeficiency virus detected in bowel epithelium from patients with gastrointestinal symptoms. Lancet, 1, 259–262.
Zeitz, M., Ullrich, R., Schneider, T., Kewenig, S., Hohlock, K., & Riecken, E. O. (1998). HIV/SIV enteropathy. Intestinal Plasticity in Health and Disease, 859, 139–148.
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Sagaert, X. (2017). Enteropathy, AIDS. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1461
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1461
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