The research, reported in the December issue of the American Journal of Gastroenterology, determined the prevalence of gastrointestinal dysfunction among HIV patients.
The team studied gastrointestinal function in 671 patients with HIV. Absorptive function was measured by a D-xylose test, a Sudan-III stain for fecal fat, and serum levels of micronutrients.
Gastrointestinal abnormalities in 671 HIV patients:
Low D-xylose absor 47.7%
Liver disease history 40.3%
Diarrhea 38.9 %
Chronic diarrhea 28.3 %
Low serum vitamin B12 22.5 %
Stool pathogens 12.2 %
Hypoalbuminemic 7.2 %
They found that 88 per cent of patients had at least one gastrointestinal function abnormality. 48 per cent had low D-xylose absorption; 40 per cent had a history of liver disease; 39 per cent had diarrhea; 28 per cent had chronic diarrhea; 23 per cent had borderline or low serum vitamin B12 levels; 12 per cent had stool pathogens; and 7 per cent were hypoalbuminemic.
Men were more likely to have low D-xylose absorption, diarrhea, and stool pathogens than women.
Intravenous drug users (IVDUs) were more likely to have a history of liver disease and hypoalbuminemia. However, borderline or low vitamin B12 levels were less frequent in IVDUs; they tended to have less diarrhea and a lower prevalence of stool pathogens.
Despite less history of liver disease, 14 per cent of women were hypoalbuminemic.
The researchers said that differences in patterns of gastrointestinal dysfunction were unlikely to be due to severity of immunosuppression, as abnormalities were seen in all risk groups with CD4 >200 cells/mm3. D-xylose absorption below 30 mg/dl, current diarrhea, and borderline levels of vitamin B12 were associated with advanced immunosuppression.
Dr T. A. Knox concluded on behalf of the group, "Abnormalities of gastrointestinal function are common in the current era of HIV treatment, appear early in the course of HIV infection, and in the absence of diarrhea.
"Gender and IVDU are important determinants of the type and frequency of gastrointestinal abnormalities."