GASTROINTESTINAL SYMPTOMS IN AMBULATORY HIV-INFECTED PATIENTS

Gastrointestinal symptoms are commonly seen in patients with establish ed AIDS. We examined the charts of 258 HIV-infected patients attending our HIV outpatient clinic to determine: (1) the frequency of gastroin testinal symptoms in unselected HIV-infected patients and (2) if there are any predictors of the development of symptoms in initially asympt omatic patients. We found the overall frequency of gastrointestinal sy mptoms at initial presentation in our ambulatory, predominantly homose xual population of HIV-infected patients was 35% (95% CI 30-40%) with 19% having anorexia, 15% weight loss, 14% diarrhea, and 5% dysphagia. There was no association between the presence of symptoms and stool pa rasites, which were found in 51% of patients. In 165 patients who were initially asymptomatic, 72% subsequently developed symptoms over 36 m onths of actuarial follow-up. Patients with initial T4 counts <500 wer e more likely to develop symptoms. Patients with a greater degree of i mmunosuppression as indicated by a lower T4 count, are more likely to develop gastrointestinal symptoms.