PREVIOUS INFECTION WITH HELICOBACTER-PYLORI IS THE PRIMARY DETERMINANT OF SPONTANEOUS GASTRIC HYPOACIDITY IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED OUTPATIENTS

To investigate the incidence and demographics of gastric hypoacidity a mong persons infected with human immunodeficiency virus (HIV), 146 asy mptomatic subjects were evaluated with use of a radiotelemetry device (Heidelberg capsule). Gastric hypoacidity (minimum gastric pH of great er than or equal to 3) occurred in 24 subjects (17%). Demographic char acteristics, CD4 cell counts, and Helicobacter pylori serological stat us were evaluated for an association with gastric pH. Subjects with hy poacidity were more likely to have positive H. pylori serology than we re subjects without hypoacidity (15 of 24 vs. 23 of 74, respectively; P = .004), Multivariate analysis indicated that a positive H, pylori s erology was the most significant predictor of hypoacidity, accounting for an increase in gastric pH of 39%. A history of injection drug use, heterosexual transmission of HIV, and male gender were also associate d with an elevated gastric pH, CD4 cell counts did not contribute to p redictions of gastric pH. A history of H. pylori infection is relative ly common in HIV-positive black and Hispanic populations and is a pred ictor of gastric pH.