Lv Fu-Jing, Luo Xiao-Lan, Meng Xin, Jin Rui, Ding Hui-Guo, Zhang Shu-Tian
Department of Digestive Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China.
World J Gastroenterol. 2007 Nov 7;13(41):5492-6. doi: 10.3748/wjg.v13.i41.5492.
To compare the prevalence of H pylori infection, peptic ulcer, cytomegalovirus (CMV) infection and Candida esophagitis in human immunodeficiency virus (HIV)-positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections.
A total of 151 patients (122 HIV-positive and 29 HIV-negative) with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of H pylori infection, CMV, candida esophagitis and histologic chronic gastritis.
The prevalence of H pylori was less common in HIV-positive patients (22.1%) than in HIV-negative controls (44.8%; P < 0.05), and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group, HIV-positive patients had a lower incidence of peptic ulcer (20.7% vs 4.1%; P < 0.01), but a higher prevalence of chronic atrophy gastritis (6.9% vs 24.6%; P < 0.05)ìCandida esophagitis and CMV infection. Unlike HIV-negative group, H pylori infection had a close relationship to chronic active gastritis (P < 0.05). In HIV-positive patients, chronic active gastritis was not significantly different between those with H pylori infection and those without.
The lower prevalence of H pylori infection and peptic ulcer in HIV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer. The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to H pylori infection.
比较人类免疫缺陷病毒（HIV）阳性和HIV阴性患者中幽门螺杆菌（H pylori）感染、消化性溃疡、巨细胞病毒（CMV）感染和念珠菌食管炎的患病率，并评估CD4淋巴细胞对幽门螺杆菌和机会性感染的影响。
对151例有胃肠道症状的患者（122例HIV阳性和29例HIV阴性）进行上消化道内镜检查和活检。评估样本以确定幽门螺杆菌感染、CMV、念珠菌食管炎和组织学慢性胃炎的患病率。
HIV阳性患者中幽门螺杆菌的患病率（22.1%）低于HIV阴性对照组（44.8%；P<0.05），且HIV阳性患者中幽门螺杆菌的患病率与CD4计数分层呈正相关。与HIV阴性组相比，HIV阳性患者消化性溃疡的发病率较低（20.7%对4.1%；P<0.01），但慢性萎缩性胃炎（6.9%对24.6%；P<0.05）、念珠菌食管炎和CMV感染的患病率较高。与HIV阴性组不同，幽门螺杆菌感染与慢性活动性胃炎密切相关（P<0.05）。在HIV阳性患者中，有幽门螺杆菌感染和无幽门螺杆菌感染的患者之间慢性活动性胃炎无显著差异。
有胃肠道症状的HIV阳性患者中幽门螺杆菌感染和消化性溃疡的患病率较低，提示消化性溃疡发生机制不同，幽门螺杆菌感染在慢性活动性胃炎和消化性溃疡中的作用也不同。HIV阳性患者慢性活动性胃炎的病原体可能与与幽门螺杆菌感染密切相关的普通人群不同。
