Clinic of Hepato-gastroenterology, ULB, Brussels, Belgium.
Helicobacter. 2012 Apr;17(2):153-9. doi: 10.1111/j.1523-5378.2011.00929.x.
We evaluated demographic characteristics in HIV-positive patients receiving highly active antiretroviral therapy (HAART) who had upper gastrointestinal (UGI) symptoms requiring UGI endoscopy and compared the findings in patients with and without H. Pylori coinfection.
We prospectively observed all HIV-infected patients treated with antiretroviral therapy who underwent UGI endoscopy for the first time and were tested for H. pylori from January 2004 to December 2008. Data collected included the following: demographics (age, gender, ethnicity, body mass index [BMI], tobacco use, alcohol intake, and HIV risk behavior); comorbidity (viral hepatitis B or C, any organ dysfunction, or opportunistic disease); medication, including antibiotics, H2 blockers, proton pump inhibitors, and NSAIDs; CD4 cell counts, viral load; symptoms; and endoscopic and histologic diagnoses (H. pylori determined by Giemsa staining). Patients were compared according to H. pylori status (presence vs absence).
One hundred and forty-five patients were evaluated. Compared to patients without H. pylori infection (n = 97), those with H. pylori infection (n = 48) had a significantly higher CD4 cell count (p = .008), were more likely to be heterosexual (p = .047), had a higher BMI (p = .027), had a greater incidence of duodenal ulcers (p = .005), had lower viral loads (p < .01), were less likely to have received macrolide antibiotics in the last 3 months (p = .00), and had less comorbidity (p = .03). They were also more frequently of Black African than Caucasians. In multivariate analysis, being heterosexual and having a low viral load were independently associated with an increased risk of having H. Pylori coinfection.
In the antiretroviral therapy era, HIV-H. pylori coinfection is associated with a greater incidence of duodenal ulcers and higher CD4 counts, higher BMI, less comorbidity, and less frequent use of macrolides.
我们评估了接受高效抗逆转录病毒治疗（HAART）的 HIV 阳性患者中出现上消化道（UGI）症状需要进行 UGI 内镜检查的患者的人口统计学特征，并比较了合并和不合并 H. pylori 合并感染患者的内镜检查结果。
我们前瞻性观察了 2004 年 1 月至 2008 年 12 月首次接受 UGI 内镜检查并接受 H. pylori 检测的所有接受抗逆转录病毒治疗的 HIV 感染患者。收集的数据包括以下内容：人口统计学特征（年龄、性别、种族、体重指数[BMI]、吸烟、饮酒和 HIV 风险行为）；合并症（乙型或丙型病毒性肝炎、任何器官功能障碍或机会性疾病）；药物治疗，包括抗生素、H2 阻滞剂、质子泵抑制剂和 NSAIDs；CD4 细胞计数、病毒载量；症状；内镜和组织学诊断（通过吉姆萨染色确定 H. pylori）。根据 H. pylori 状态（存在或不存在）比较患者。
评估了 145 名患者。与未感染 H. pylori 的患者（n = 97）相比，感染 H. pylori 的患者（n = 48）的 CD4 细胞计数显著更高（p =.008），更有可能是异性恋（p =.047），BMI 更高（p =.027），十二指肠溃疡发生率更高（p =.005），病毒载量更低（p <.01），在过去 3 个月内接受大环内酯类抗生素治疗的可能性更低（p =.00），合并症更少（p =.03）。他们也更常为黑非洲人而不是白种人。在多变量分析中，异性恋和低病毒载量与 H. Pylori 合并感染的风险增加独立相关。
在抗逆转录病毒治疗时代，HIV-H. pylori 合并感染与十二指肠溃疡发生率增加、CD4 计数更高、BMI 更高、合并症更少、大环内酯类抗生素使用频率更低有关。
