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Influence of anti-retroviral treatment on gastric secretion, Helicobacter pylori colonisation of gastric mucosa and fungal colonisation of upper gastrointestinal tract in HIV-infected patients

Abstract number: P784

Skwara P., Ciesla A., Sobczyk-Krupiarz I., Bociaga M., Kalinowska-Nowak A., Mach T.

Objectives: HIV infection is considered to have negative influence on gastric acid juice secretion and results in higher prevalence of fungal colonisation of upper gastrointestinal (GI) tract, whereas Helicobacter pylori (Hp) prevalence in stomach seems to be lower in HIV-infected patients (pts). The aim of the study was to estimate influence of antiretroviral treatment (HAART) on gastric secretion, Hp colonisation of stomach and fungal colonisation of upper GI tract.

Methods: 94 HIV-infected pts were studied, half of them had CD4 lymphocyte count <200/uL. 9 of 21 pts receiving HAART belonged to this group. Biopsy samples were taken during endoscopy from corpus and antrum of stomach to confirm presence of Hp by histological analysis and rapid urease test. Quantitative mycologic cultures from oral and oesophageal swabs were analysed in 70 pts. Gastric secretion was evaluated in 37 pts using Kay method on the basis of BAO, MAO and PAO. The results were compared to HIV viral load (VL) detected by PCR.

Results: VL decrease correlated with increased BAO (correlation coefficient r=-0.165), MAO (r=-0.287) and PAO (r=-0.289) and decreased BAO/MAO ratio (r=0.22). Prevalence of Hp in pts on HAART in comparison to the rest of pts, was lower in both corpus of stomach (28%vs48%) and antrum (38%vs62%) /p > 0.05/. Hp was present in corpus and antrum (respectively) in 29%/47% of pts with VL < 500 copies/mL and 44%/49% of pts with higher VL /p > 0.05/. Fungal colonisation rate in pts on HAART (vs the rest of pts) was lower in both oral cavity (64%vs87%) and oesophagus (64%vs84%) /p > 0.05/. Lower prevalence of fungal colonisation in pts with VL < 500 copies/mL (vs the rest of pts) was found in oral cavity (67%vs90%) /p > 0.05/ and oesophagus (58%vs87%) /p < 0.05/.

Conclusions: Inhibited HIV replication due to antiretroviral therapy results in increase in gastric secretion, as well as decrease in fungal colonisation of the upper GI tract and Hp colonisation of stomach.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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