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Impaired intestinal function in symptomatic HIV infection.

A Guarino1, L Tarallo, S Guandalini

  • 1Department of Pediatrics, University of Naples, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|May 1, 1991
PubMed
Summary

Children with symptomatic human immunodeficiency virus (HIV) infection on antimicrobial prophylaxis experienced impaired intestinal function, despite uncommon severe diarrhea. Intestinal permeability and nutrient absorption were frequently affected.

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Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Immunology

Background:

  • Symptomatic human immunodeficiency virus (HIV) infection can impact various organ systems.
  • Intestinal dysfunction is a potential complication in pediatric HIV patients.
  • Antimicrobial prophylaxis is often used in children with HIV.

Purpose of the Study:

  • To evaluate intestinal symptoms and function in children with symptomatic HIV receiving antimicrobial prophylaxis.
  • To identify potential enteric pathogens and assess intestinal function over a 10-22 month period.

Main Methods:

  • Longitudinal study of five children with symptomatic HIV infection.
  • Repeated assessments including enteric pathogen screening and intestinal function tests.
  • Specific tests included D-xylose and iron oral loads, steatorrhea, alpha 1-antitrypsin fecal excretion, intestinal permeability, and food antibody levels.

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Main Results:

  • Mild diarrhea occurred in two children; one had cow's milk protein intolerance.
  • Giardia lamblia was identified in an asymptomatic child.
  • All patients demonstrated evidence of impaired intestinal function, including abnormal D-xylose and iron absorption, increased steatorrhea, elevated alpha 1-antitrypsin, compromised intestinal permeability, and heightened food antibody levels.

Conclusions:

  • Severe diarrhea appears uncommon in HIV-infected children on antimicrobial prophylaxis.
  • However, intestinal function is frequently and significantly impaired in this population.
  • The findings highlight the subclinical intestinal impact of HIV infection even with prophylactic treatment.