Intestinal absorptive capacity, intestinal permeability and jejunal histology in HIV and their relation to diarrhoea.

J Keating, I Bjarnason, S Somasundaram, A Macpherson, N Francis, A B Price, D Sharpstone, J Smithson, I S Menzies, B G Gazzard

Department of Medicine, Chelsea and Westminster Hospital, London.

Intestinal function is poorly defined in patients with HIV infection. Absorptive capacity and intestinal permeability were assessed using 3-O-methyl-D-glucose, D-xylose, L-rhamnose, and lactulose in 88 HIV infected patients and the findings were correlated with the degree of immunosuppression (CD4 counts), diarrhoea, wasting, intestinal pathogen status, and histomorphometric analysis of jejunal biopsy samples. Malabsorption of 3-O-methyl-D-glucose and D-xylose was prevalent in all groups of patients with AIDS but not in asymptomatic, well patients with HIV. Malabsorption correlated significantly (r = 0.34-0.56, p < 0.005) with the degree of immune suppression and with body mass index. Increased intestinal permeability was found in all subgroups of patients. The changes in absorption-permeability were of comparable severity to those found in patients with untreated coeliac disease. Jejunal histology, however, showed only mild changes in the villus height/crypt depth ratio as compared with subtotal villus atrophy in coeliac disease. Malabsorption and increased intestinal permeability are common in AIDS patients. Malabsorption, which has nutritional implications, relates more to immune suppression than jejunal morphological changes.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Epple, H-J, Schneider, T, Troeger, H, Kunkel, D, Allers, K, Moos, V, Amasheh, M, Loddenkemper, C, Fromm, M, Zeitz, M, Schulzke, J-D (2009). Impairment of the intestinal barrier is evident in untreated but absent in suppressively treated HIV-infected patients. Gut 58: 220-227 [Abstract] [Full Text]  
• Ramachandran, G., Hemanthkumar, A.K., Rajasekaran, S., Padmapriyadarsini, C., Narendran, G., Anitha, S., Subramanyam, S., Kumaraswami, V., Swaminathan, S. (2007). Steady-State Pharmacokinetics of Nevirapine in HIV-1 Infected Adults in India. J Int Assoc Physicians AIDS Care (Chic Ill) 6: 251-254 [Abstract]  
• Orandle, M. S., Veazey, R. S., Lackner, A. A. (2007). Enteric Ganglionitis in Rhesus Macaques Infected with Simian Immunodeficiency Virus. J. Virol. 81: 6265-6275 [Abstract] [Full Text]  
• Arrieta, M C, Bistritz, L, Meddings, J B (2006). Alterations in intestinal permeability.. Gut 55: 1512-1520 [Full Text]  
• KELLY, P., MENZIES, I., CRANE, R., ZULU, I., NICKOLS, C., FEAKINS, R., MWANSA, J., MUDENDA, V., KATUBULUSHI, M., GREENWALD, S., FARTHING, M. (2004). RESPONSES OF SMALL INTESTINAL ARCHITECTURE AND FUNCTION OVER TIME TO ENVIRONMENTAL FACTORS IN A TROPICAL POPULATION. Am J Trop Med Hyg 70: 412-419 [Abstract] [Full Text]  
• Trout, H., Mentre, F., Panhard, X., Kodjo, A., Escaut, L., Pernet, P., Gobert, J.-G., Vittecoq, D., Knellwolf, A.-L., Caulin, C., Bergmann, J.-F. (2004). Enhanced Saquinavir Exposure in Human Immunodeficiency Virus Type 1-Infected Patients with Diarrhea and/or Wasting Syndrome. Antimicrob. Agents Chemother. 48: 538-545 [Abstract] [Full Text]  
• Singhal, N., Austin, J. (2002). A Clinical Review of Micronutrients in HIV Infection. J Int Assoc Physicians AIDS Care (Chic Ill) 1: 63-75 [Abstract]  
• Sharpstone, D, Neild, P, Crane, R, Taylor, C, Hodgson, C, Sherwood, R, Gazzard, B, Bjarnason, I (1999). Small intestinal transit, absorption, and permeability in patients with AIDS with and without diarrhoea. Gut 45: 70-76 [Abstract] [Full Text]  
• Menzies, I S, Zuckerman, M J, Nukajam, W S, Somasundaram, S G, Murphy, B, Jenkins, A P, Crane, R S, Gregory, G G (1999). Geography of intestinal permeability and absorption. Gut 44: 483-489 [Abstract] [Full Text]  
• Sigthorsson, G, Tibble, J, Hayllar, J, Menzies, I, Macpherson, A, Moots, R, Scott, D, Gumpel, M J, Bjarnason, I (1998). Intestinal permeability and inflammation in patients on NSAIDs. Gut 43: 506-511 [Abstract] [Full Text]  
• Carroccio, A, Fontana, M, Spagnuolo, M I, Zuin, G, Montalto, G, Canani, R B, Verghi, F, Di Martino, D, Bastoni, K, Buffardi, F, Guarino, A (1998). Pancreatic dysfunction and its association with fat malabsorption in HIV infected children. Gut 43: 558-563 [Abstract] [Full Text]  
• Carbonnel, F, Beaugerie, L, Rached, A A., D'Almagne, H, Rozenbaum, W, Le Quintrec, Y, Gendre, J P, Cosnes, J (1997). Macronutrient intake and malabsorption in HIV infection: a comparison with other malabsorptive states. Gut 41: 805-810 [Abstract] [Full Text]