Prevalence of Helicobacter pylori prevalence and upper gastrointestinal endoscopy in HIV/AIDS patients with gastrointestinal symptoms in the University Teaching Hospitals in Cameroon.

OBJECTIVE

To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts.

MATERIAL AND METHODS

In all, 56 HIV patients and 56 age- and sex-matched HIV controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA).

RESULTS

The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV patients between those with a CD4 count ≥200/mm (52%) and those with a CD4 count <200/mm (42%) (p = 0.62). The prevalence on endoscopy of specific lesions in HIV patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; p<0.0001), esophageal ulcers (18%, 10/56 vs 2%; p = 0.01), corpus gastritis (41%; 23/56 vs 5%; p<0.0001), and duodenitis (20%, 11/56, vs 0%; p = 0.001).

CONCLUSIONS

The prevalence rate of H. pylori did not differ significantly between HIV and HIV subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV patients with CD4 T-cell counts below 200/mm. On endoscopy, esophageal candidiasis was the most common finding in HIV patients, discovered by dysphagia.