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No relationship between gastric pH, small bowel bacterial colonisation, and diarrhoea in HIV-1 infected patients

C M Wilcox1, K B Waites, P D Smith

  • 1Departments of Medicine (Gastroenterology and Hepatology) and Pathology, University of Alabama at Birmingham, Birmingham, AL 39294-0007, USA.

Gut
|December 24, 1998
PubMed
Abstract

Insights

Small bowel bacterial overgrowth is uncommon in patients with Human Immunodeficiency Virus type 1 (HIV-1) infection. Bacterial quantity and species did not correlate with diarrhea, gastric acidity, or immune deficiency severity.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Microbiology

Background:

  • Limited conclusive studies exist on small bowel bacterial overgrowth (SBBO) in Human Immunodeficiency Virus type 1 (HIV-1) infected patients.
  • Investigating the relationship between proximal small intestine bacterial composition and clinical factors in HIV-1 is crucial.

Purpose of the Study:

  • To determine the relationship between the quantity and species of bacteria in the proximal small intestine of HIV-1 infected patients.
  • To assess the correlation with diarrhea, gastric acidity, immune deficiency severity, and clinical outcome.

Main Methods:

  • Duodenal fluids from 32 HIV-1 patients (21 with diarrhea) and 7 controls were analyzed for bacterial quantification and speciation.
  • Gastric pH was measured during endoscopy, and clinical follow-up was conducted.

Main Results:

  • Oropharyngeal Gram-positive cocci were prevalent (88%).
  • Gram-negative aerobic/facultative anaerobic bacteria (38%) and strict anaerobes (19%) were detected, but colony counts rarely exceeded 10(4) CFU/ml.
  • Bacterial numbers and species did not correlate with diarrhea, gastric pH, or CD4+ T-cell count.

Conclusions:

  • Small bowel bacterial overgrowth is not common in HIV-1 infected patients.
  • SBBO is not associated with diarrhea or hypochlorhydria in this population.

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