HELICOBACTER-PYLORI INFECTION IN HIV-POSITIVE PATIENTS - A SEROHISTOLOGICAL STUDY

Sixty-seven consecutive patients infected with the human immunodeficie ncy virus (HIV-1), 72% of which with overt AIDS, were examinated by up per endoscopy due to various indications and evaluated for the prevale nce of H. pylori infection. The infection was studied by performing bo th histological examination of gastric biopsies and serological testin g for anti-H. pylori IgG antibodies. The H. pylori prevalence rate was 55% in histology; no significant differences were observed in HIV-inf ected subjects and those with overt AIDS (52% vs 63%, respectively; P = NS). Positive histological testing appeared to be directly related t o the peripheral CD4(+) lymphocyte count (minimum rates of 43% were de tected in patients with CD4(+) <100 X 10(6)/liter and maximum rates of 78% in patients with CD4(+) >200 X 10(6)/liter, respectively; P < 0.0 5) and inversely related to the frequency of antibiotic treatments per formed over the six months prior to endoscopy. Low CD4(+) counts were also apparently associated with low-grade H. pylori infection. Serolog ical testing was positive for anti-H. pylori IgG antibodies in 39% of patients; compared to histology, serology displayed a sensitivity of 5 7% and a specificity of 81%. The discrepancy between histological and serological positive results for H. pylori was noted to be higher in t he more advanced phases of HIV infection. Based upon our results, the serological testing for anti-H. pylori IgG antibodies seems to require cautious interpretation in HIV-positive patients.