In a prospective case control study, the authors investigated occult enteric infections and duodenal morphologic changes in patients with advanced HIV infection and chronic diarrhea. Twenty‐two patients with advanced HIV infection (AIDS, 19; ARC, 3) with chronic diarrhea (<1 month) and previously negative infectious stool evaluations, were compared with 13 patients with advanced HIV infection (AIDS, 9; ARC, 4) without diarrhea by analyzing endoscopic biopsies using light and electron microscopy (EM), viral culture, and duodenal morphometric studies. Sigmoid biopsies were also obtained in 21 of the diarrhea patients and five of the nondiarrhea patients. Occult enteric infections were found in half of the diarrhea group, hut in only one of the patients without diarrhea. Microsporida and Mycobacterium avium‐intracellulare (MAI) were the most common pathogens. Microsporida were found only in the small intestine, whereas the few pathogens found in the colon were also present in the small bowel mucosa. Villus and crypt architecture alterations were similar in the two groups, but significantly different from normal controls, and independent of diarrhea or enteric infection. Patients with diarrhea and occult enteric pathogens had greater weight loss (14.3 kg vs. 6.2 kg, p < 0.05) and shorter survival (p < 0.004) than diarrhea patients without identified pathogens.
|Original language||English (US)|
|Number of pages||2|
|Journal||The American Journal of Gastroenterology|
|Publication status||Published - Nov 1991|
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