UNCERTAIN CLINICAL-SIGNIFICANCE OF DUODENAL MUCOSAL ABNORMALITIES IN HIV-INFECTED INDIVIDUALS - RESULTS OF A CASE-CONTROL STUDY

Previous research has described abnormalities of duodenal mucosal morp hology in human immunodeficiency virus (HIV)-infected individuals. We wanted to determine the frequency of disturbed villus architecture and investigate its relationship to HIV-related chronic diarrhea. We cond ucted a case-control study of 120 HIV-infected men, 63 with and 57 wit hout chronic diarrhea. Stools were cultured for bacteria and examined for ova and parasites; esophagogastroduodenoscopy and flexible sigmoid oscopy with mucosal biopsies were performed. Biopsy tissue was examine d using light and electron microscopy to detect enteric pathogens and to evaluate mucosal morphology. The mean CD4(+) cell count was 143/mm( 3), and enteric pathogens were detected in 56 of 120 men (47%). In app roximately half the study sample (57%), duodenal villus architecture w as normal; complete villus flattening was not observed. We detected no association between chronic diarrhea and altered villus architecture. Although further study is needed to clarify the pathogenesis of alter ed duodenal mucosal morphology, our results suggest that the clinical significance of the abnormalities may be small.