Evaluation of upper gastro intestinal endoscopy among HIV positive and negative patients at a tertiary care hospital: a comparative study

Authors

  • Ramapriya Rengaswamy Department of General Medicine, Consultant Physician, Poulomi Hospital, AS Rao Nagar, Hyderabad, Telangana, India
  • Thayumanavan L. Department of Medical Gastroenterology, Consultant Medical Gastroenterologist, Apollo Hospital, Vangaram, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20183896

Keywords:

Endoscopic findings, Gastrointestinal, Gastritis

Abstract

Background: Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms.  The objective of the present research was to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients.

Methods: A comparative study was carried out in the department of General Medicine to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients for a period of two years. 101 cases who were HIV positive were compared with equal number of HIV negative subjects. The subjects in the case group as well as control group were chosen randomly.

Results: There was a significant lower incidence of Helicobacter pylori positivity (38.6%) among HIV positive patients when compared to controls (73.6%). There were overall 63 patients with abnormal biopsy findings in HIV group and 75 patients with abnormal biopsy findings in the control group. Among HIV positive patients who were also RUT positive approximately 80% had abnormal histopathological findings. Similarly, among the RUT positive control 81% of the patients had abnormal biopsy findings. Incidence of normal biopsy findings was more in the control group (57.1%) compared to the study group (48.4%). But this difference was not found to be statistically significant.

Conclusions: The histology of gastric mucosa was no different in Helicobacter pylori positive or negative subjects with HIV. But Helicobacter pylori incidence was significantly less in HIV positive persons compared to HIV negative.

References

Blattner WA. HIV epidemiology: past, present and future. Federation of American Societies for Experimental Biology. (FASEB J) 1991;5:2340.

Knox TA, Spiegelman D, Skinner SC, Gorbach S. Diarrhea and abnormalities of gastrointestinal function in a cohort of men and women with HIV infection. Am J Gastroenterol. 2000 Dec; 95(12):3482-9.

Di Lollo S, Tozzinni S. Pathology. In: Dionisio D, editor. Textbook-Atlas of Intestinal Infections in AIDS. Milan, Italia: Springer. 2003:211-231.

Bhaijee F, Subramony C, Tang SJ, Pepper DJ. Human Immunodeficiency Virus associated gastrointestinal disease: Common endoscopic biopsy diagnoses. Pathology Res Int. 2011;2011:247923.

Fabris P, Bozzola L, Benedetti P, Scagnelli M, Nicolin R, Manfrin V, et al. H. pylori Infection in HIV-Positive Patients (A Serohistological Study). Dig Dis Sci. 1997 Feb 1;42(2):289-92.

Carrick J, Lee A, Hazell S, Ralston M, Daskalopoulos G. Campylobacter pylori, duodenal ulcer, and gastric metaplasia: possible role of functional heterotopic tissue in ulcerogenesis. Gut. 1989;30(6):790-7.

Suzuki H, Hibi T, Marshall BJ. Helicobacter pylori: present status and future prospects in Japan. J Gastroenterol. 2007;42(1):1-5.

Sipponen P. Helicobacter pylori: epidemiology. J Gastroenterol. 1997;32(2):273-7.

Holcombe C, Kaluba J, Lucas SB. Helicobacter pylori infection and gastritis in healthy Nigerians. Eur J Epidemiol. 1994;10(2):223-5.

Rolston KVL, Rodriguez S. Upper GI disease in HIV infected individual. Arch Intern Med. 1992;152:881-2.

Lim SG, Lipman SS. Audit of endoscopic surveillance of biopsy specimen in HIV positive patients with GIT symptoms. Gut. 1993;34(10):1429-32.

Wernet-Silva AL, Prado IB. Dyspepsia in HIV infected patients under highly active anti-retroviral therapy. J Gastroenterol Hepat. 2007;22(11):1712-6.

Downloads

Published

2018-09-22

Issue

Section

Original Research Articles