Ribeiro Machado F, Gonzaga Vaz Coelho L, Chausson Y, Greco D B
Infections and Parasitic Diseases Service, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Brazil.
J Clin Gastroenterol. 2000 Jun;30(4):403-8. doi: 10.1097/00004836-200006000-00010.
The aim of this study was to evaluate fat absorption in HIV-positive (HIV+) patients in different phases of HIV infection using a 14C-triolein breath test. We distributed 47 HIV+ patients according to the 1993 Centers for Disease Control Revised Classification: 20 in Group 2 (A1 or A2) and 27 in Group 3 (B1, B2, A3, B3, or C). Ten HIV-negative healthy subjects comprised the control group (Group 1). All individuals underwent a 14C-triolein breath test. Parasitic infection was evaluated through three stool exams, including Cryptosporidium and Isospora investigation. The median value of cumulative 6 hours' 14C excretion expressed as percentage of the 14C given as triolein was significantly higher in Group 1 (8.4%) than Group 2 (5.5%) or Group 3 (3.4%), p = 0.04 and p << 0.01, respectively. Fat malabsorption was found in 25% of Group 2 individuals, 52.6% of those without diarrhea in Group 3, and was correlated with CD4+ lymphocyte counts (p << 0.01). Fat malabsorption is a common feature in advanced stages of HIV infection, even in the absence of diarrhea and is also present in asymptomatic HIV+ patients. These findings suggest that malabsorption is an early event in HIV-infected individuals and is correlated with the degree of immunosuppression.
本研究的目的是使用14C-三油酸甘油酯呼气试验评估处于不同HIV感染阶段的HIV阳性（HIV+）患者的脂肪吸收情况。我们根据1993年美国疾病控制中心修订分类法将47例HIV+患者进行了分组：2组（A1或A2）20例，3组（B1、B2、A3、B3或C）27例。10名HIV阴性健康受试者组成对照组（1组）。所有个体均接受了14C-三油酸甘油酯呼气试验。通过三次粪便检查评估寄生虫感染情况，包括隐孢子虫和等孢子球虫检查。以三油酸甘油酯形式给予的14C的累积6小时排泄量的中位数，以其占给予的14C的百分比表示，1组（8.4%）显著高于2组（5.5%）或3组（3.4%），p值分别为0.04和p << 0.01。2组中25%的个体存在脂肪吸收不良，3组中无腹泻的个体有52.6%存在脂肪吸收不良，且与CD4+淋巴细胞计数相关（p << 0.01）。脂肪吸收不良是HIV感染晚期的常见特征，即使在无腹泻的情况下也存在，并且在无症状的HIV+患者中也存在。这些发现表明吸收不良是HIV感染个体中的早期事件，并且与免疫抑制程度相关。
