AIDS. 1993 Nov;7(11):1435-40.
To determine the features and the prevalence of intestinal-dysfunction in HIV-infected children and to investigate its relationship to diarrhoea, growth failure, immune dysfunction and enteric pathogens.
Case controlled, cross-sectional multicentre study.
Children enrolled in tertiary care Italian centres for paediatric HIV infection from June 1990 to June 1992. Intestinal function tests and investigation for enteric viruses were performed in Naples.
Forty-seven children with symptomatic HIV infection, six of whom had diarrhoea. Fifty non-infected children with diarrhoea and 48 healthy children were enrolled as controls for enteric viruses positivity and intestinal tests.
Intestinal function was investigated by measuring fat, protein and carbohydrate adsorption using the steatocrit method, and determining the faecal concentration alpha-1-antitrypsin and the d-xylose absorption, respectively. Microbiological studies included investigation for classical and opportunistic pathogens and for enteric viruses by electron microscopy in the stools of HIV-infected children. The presence of viruses in the stools of HIV-negative children was also investigated.
A high prevalence of intestinal-dysfunction was detected in HIV-infected children; faecal fat loss was detected in 14 out of 47 (30%), carbohydrate malabsorption in 15 out of 47 (32%) and protein loss in eight out of 47 (17%) HIV-infected children. Mean values of xylose blood level and of steatocrit were significantly different from those of healthy controls. Four children with diarrhoea were positive for Cryptosporidium. The prevalence of enteric viruses was significantly increased in HIV-infected children (57%) compared with healthy controls (17%). Intestinal-dysfunction was not associated with diarrhoea, poor growth, enteric agents or degree of immune dysfunction.
Intestinal-dysfunction, consisting of fat, carbohydrate and protein malabsorption, is a common feature of paediatric HIV infection. Although not clinically evident, it may contribute to further worsening of the disease.
确定感染人类免疫缺陷病毒（HIV）儿童肠道功能障碍的特征及患病率，并研究其与腹泻、生长发育迟缓、免疫功能障碍和肠道病原体的关系。
病例对照横断面多中心研究。
1990年6月至1992年6月在意大利三级护理儿科HIV感染中心登记的儿童。在那不勒斯进行肠道功能测试和肠道病毒调查。
47例有症状的HIV感染儿童，其中6例有腹泻。50例未感染腹泻儿童和48例健康儿童作为肠道病毒阳性和肠道测试的对照。
采用脂肪血细胞比容法测量脂肪、蛋白质和碳水化合物吸收，并分别测定粪便中α-1抗胰蛋白酶浓度和d-木糖吸收，以研究肠道功能。微生物学研究包括对HIV感染儿童粪便中的经典和机会性病原体以及肠道病毒进行调查，通过电子显微镜检查。还对HIV阴性儿童粪便中的病毒进行了调查。
在HIV感染儿童中检测到高患病率的肠道功能障碍；47例HIV感染儿童中，14例（30%）检测到粪便脂肪流失，15例（32%）碳水化合物吸收不良，8例（17%）蛋白质流失。木糖血水平和脂肪血细胞比容的平均值与健康对照组有显著差异。4例腹泻儿童隐孢子虫检测呈阳性。与健康对照组（17%）相比，HIV感染儿童肠道病毒的患病率显著增加（57%）。肠道功能障碍与腹泻、生长发育不良、肠道病原体或免疫功能障碍程度无关。
由脂肪、碳水化合物和蛋白质吸收不良组成的肠道功能障碍是儿科HIV感染的常见特征。虽然在临床上不明显，但它可能导致疾病进一步恶化。
