GASTRIC AND DUODENAL BACTERIAL-COLONIZATION IN HIV-INFECTED PATIENTS WITHOUT GASTROINTESTINAL SYMPTOMS

Objective: To assess the prevalence of gastric and duodenal bacterial colonization in HIV-infected patients. Methods: Twenty-three consecuti ve outpatients at various stages of HIV infection were examined. No pa tient received antibiotic therapy or antisecretory drugs, and none pre sented with digestive symptoms. A second group consisted of 39 patient s without risk factors for HIV infection referred to the gastroenterol ogy outpatient clinic for suspected peptic ulcer disease. Gastric and duodenal juices were aspirated separately through the endoscope under direct visual control, using a sterilized double-sheathed tube. Specim ens were plated quantitatively for both aerobic and anaerobic organism s. Parasitological evaluation was done on duodenal samples. Results: g astric and/or duodenal bacterial colonization was documented in 7/23 ( 30%) HIV+ patients and in 3/39 (8%) patients in the second group (p < 0.05). No parasites were detected. All isolates were oral Grampositive cocci or bacilli. Mean fasting gastric pH was significantly higher in HIV-infected patients with bacterial colonization than in HIV-infecte d patients and patients in the second group without bacterial coloniza tion (p < 0.02). There was no correlation between the presence of bact erial colonization and CD4+ cells counts. Conclusion: HN infection may predispose to asymptomatic digestive bacterial colonization. Further studies are needed to assess the role of bacterial colonization in sym ptomatic patients presenting with diarrhea and/or weight loss.