INTESTINAL ABSORPTIVE-CAPACITY, INTESTINAL PERMEABILITY AND JEJUNAL HISTOLOGY IN HIV AND THEIR RELATION TO DIARRHEA

Intestinal function is poorly defined in patients with HIV infection. Absorptive capacity and intestinal permeability were assessed using 3- O-methyl-D-glucose, D-xylose, L-rhamnose, and lactulose in 88 HDV infe cted patients and the findings were correlated with the degree of immu nosuppression (CD4 counts), diarrhoea, wasting, intestinal pathogen st atus, and histomorphometric analysis of jejunal biopsy samples. Malabs orption of 3-O-methyl-D-glucose and D-xylose was prevalent in all grou ps of patients with AIDS but not in asymptomatic, well patients with H IV. Malabsorption correlated significantly (r = 0.34-0.56, p < 0.005) with the degree of immune suppression and with body mass index. Increa sed intestinal permeability was found in all subgroups of patients. Th e changes in absorption-permeability were of comparable severity to th ose found in patients with untreated coeliac disease. Jejunal histolog y, however, showed only mild changes in the villus height/crypt depth ratio as compared with subtotal villus atrophy in coeliac disease. Mal absorption and increased intestinal permeability are common in AIDS pa tients. Malabsorption, which has nutritional implications, relates mor e to immune suppression than jejunal morphological changes.