AIDS enteropathy: what's in a name?

The term acquired immunodeficiency syndrome (AIDS) enteropathy was first used in 1984 to refer to changes in intestinal structure and function in human immunodeficiency virus (HIV)-infected patients. Since then, confusion has arisen regarding the meaning of the term. To identify the sources of this confusion we performed a methodologic critique of published clinical research on the topic. We carried out a literature search to identify clinical studies that included at least 20 subjects. Among the six cross-sectional studies we identified, no consensus exists regarding the term itself, to whom it applies, the elements on which it is based, and the criteria for its definition. Further, methodologic problems pertaining to the selection of cases and controls limited the conclusions that could be drawn from these studies. Alterations of mucosal structure and function occur in some HIV-infected patients. However, the nature of these alterations and their relationships to symptoms (diarrhea), immune function, and enteric pathogens remain unclear. Further research is needed to develop a taxonomy for AIDS enteropathy. In carrying out this research, attention to methodologic issues will be important.