The Prevalence and Severity of Intestinal Disaccharidase Deficiency in Human Immunodeficiency Virus-Infected Subjects
| Autor: | Brian Gazzard, Chris Taylor, Ingvar Bjarnason, G Sigthorsson, D Sharpstone, M Coutts, R Sherwood, K Hodgson, I S Menzies |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment AIDS-related complex HIV Infections Comorbidity Biology Disaccharidases Severity of Illness Index Gastroenterology Statistics Nonparametric Intestinal absorption Acquired immunodeficiency syndrome (AIDS) Intestinal mucosa Reference Values Immunopathology Internal medicine Prevalence medicine Humans Intestinal Mucosa Aged Acquired Immunodeficiency Syndrome Chi-Square Distribution Biopsy Needle Biological Transport Lactase Jejunal Diseases Middle Aged medicine.disease Disaccharidase Diarrhea Intestinal Absorption Immunology medicine.symptom |
| Zdroj: | Scandinavian Journal of Gastroenterology. 35:599-606 |
| ISSN: | 1502-7708 0036-5521 |
| DOI: | 10.1080/003655200750023552 |
| Popis: | Background: Gastrointestinal symptoms are distressing features of human immunodeficiency virus (HIV) ) infection, and management is often empirical, including withdrawal of dietary lactose. We assessed the prevalence and severity of intestinal disaccharidase deficiency in vitro and in vivo. Methods: Fifty-four HIV-seropositive patients (19 HIV well ± mild diarrhoea, 7 acquired immunodeficiency syndrome (AIDS) well, and 28 AIDS with diarrhoea) were studied with a combined non-invasive absorption-permeability-disaccharidase test that enables quantitative assessment of the rate of intestinal hydrolysis of lactose, sucrose, and palatinose. Thirty patients had jejunal biopsy specimens suitable for histomorphometric assessment, and 36 had in vitro disaccharidase activity measurement. Results: Patients with HIV (with mild diarrhoea) and AIDS (with and without severe diarrhoea) had frequent hut mild histomorphometric changes in jejunal specimens. This was associated with frequent (21%-100%) and often severe in vitro jejunal disaccharidase deficiency. In vivo hydrolysis of lactose, sucrose, and palatinose was impaired in 25%-75% of patients, apart from HIV well patients, who were normal. The prevalence of the in vivo lactase and sucrase deficiency was significantly (P < 0.006) lower than in vitro and severe in about 30%. Conclusions: Intestinal disaccharidase deficiency is common both in vitro and in vivo in HIV-seropositive patients hut sufficiently severe to consider lactose withdrawal only in about a quarter of the patients with AIDS and diarrhoea. |
| Databáze: | OpenAIRE |
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