Introduction Diarrhoea is the most common gastrointestinal symptom in patients with HIV. Faecal calprotectin (FCP) is a useful test in the investigation of chronic diarrhoea in the general population.1 The sensitivity of this test in HIV-patients with chronic diarrhoea is unknown.
Methods HIV-positive patients undergoing investigation for CD between January 2011 and August 2013 were identified. Demographics and clinical data including measurement of FCP and endoscopy findings were taken from the patients medical records
Results 60 patients were referred by the HIV team to Gastroenterology clinic for investigation of CD. There were 55 (92%) males, mean age was 44 years. All were receiving antiretroviral therapy. No patients had a previous history of Inflammatory Bowel Disease (IBD), 59/60 had negative stool cultures. One patient was diagnosed with giardiasis and excluded from the study. Of the remaining, 54/59 (92%) patients had FCP measured, of which 36 (67%) demonstrated inflammation. Of these 31/36 (87%) patients with elevated FCP underwent lower GI endoscopy. 9/31 (30%) patients had abnormal macroscopic findings including mild non-specific inflammatory changes (4/31), polyps (2/31), threadworms (1/31) and ileitis (2/31). None had evidence of IBD.
Conclusion In HIV positive individuals receiving antiretroviral therapy 30% patients with elevated FCP had macroscopic disease. No patients had a diagnosis of IBD. No cause beyond anti-retroviral medication was found. FCP is not a useful test to investigate chronic diarrhoea in this patient cohort.
Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2006 Jun;12(6):524–34
Disclosure of Interest None Declared.