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Relationship between gastric secretion, bacterial and fungal colonisation and histological changes in gastric mucosa in HIV-infected patients

Abstract number: P997

Skwara P., Sobczyk-Krupiarz I., Ciesla A., Loster J., Mach T.

Objectives: Abnormal secretion of acid gastric juice in the course of HIV infection may result in bacterial and fungal overgrowth in stomach. The aim of the study was to estimate gastric secretion in HIV-infected patients (pts) in relation to severity of immunodeficiency and route of HIV transmission as well as influence of changes in gastric secretion on bacterial and fungal colonisation of stomach and gastric mucosa histology.

Methods: 71 HIV-infected pts were studied, 35 with CD4 lymphocyte count <200/uL (group 1) and 36 with CD4 >200/uL (group 2). Biopsy samples were taken during endoscopy from corpus and antrum of stomach for histological analysis and gastric juice samples were taken for quantitative bacteriological and mycological analysis. Gastric secretion was evaluated in 37 pts belonging to group 1 (19pts) and group 2 (18pts) on the basis of BAO, MAO and PAO analysis. In this group, route if transmission in 21 pts was intravenous (drug addicts), whereas sexual in the rest of patients.

Results: However no statistically significant difference in BAO between the two groups was noted, statistically significant decrease in gastric secretion /p<0.05/ was found in group 1 in comparison to group 2 (MAO 11.8vs18.3; PAO 14.8vs22.7 mmol HCl/h). Such relationship appeared to be much more evident in pts infected via sexual route (MAO 7.4vs20; PAO 9.3vs25). Gastric juice culture in pts with MAO<10 mmol HCl/h in comparison to the rest of pts, revealed more frequent significant growth of both fungi (58%vs32%) and bacteria (33%vs8%). Pts with fungal colonisation >104 CFU/mL had lower BAO (1.8vs3.3), MAO (11.2vs17.5) and PAO (14.5vs21.5) in comparison to the rest of pts. Similarly, pts with bacterial colonisation >104CFU/mL had lower BAO (1.3vs3.0), MAO (8.8vs16.1) and PAO (11.2vs20.1). No statistically significant correlation was found between bacterial colonisation and histological changes in gastric mucosa except for higher prevalence of chronic active gastritis in corpus of stomach /p<0.05/. Fungal colonisation correlated with higher prevalence of chronic non-active gastritis in corpus of stomach /p<0.01/.

Conclusions: Significant decrease in gastric secretion was found in severely immunocompromised HIV-infected pts, provided they were not intravenously infected drug addicts, followed by more frequent bacterial colonisation which correlated with chronic active gastritis and fungal colonisation which correlated with chronic non-active gastritis in corpus 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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