Benz J, Hasbach H, Brenden M, Eidt S, Fätkenheuer G, Schrappe M, Geisel J, Goossens H, Mauff G
Institut für Medizinische Mikrobiologie und Hygiene, Universität zu Köln, Germany.
Zentralbl Bakteriol. 1993 Sep;280(1-2):186-96. doi: 10.1016/s0934-8840(11)80955-2.
The prevalence of H. pylori associated gastritis seems to be different in HIV positive and HIV negative patients. Therefore a correlation to immunodeficiency can be postulated. The histology of gastritis, status of H. pylori infection and parameters of humoral and cellular immune response were investigated in 41 HIV positive and 47 HIV negative patients, who were subjected to upper endoscopy for the evaluation of gastrointestinal symptoms. In HIV positive patients 37% had active chronic gastritis against 62% of the HIV negative patients. In 73% of HIV positive cases of active chronic gastritis H. pylori was detected by bacteriological culture and/or Warthin-Starry stain. In HIV negative patients active chronic gastritis was always associated to H. pylori infection. Production of antibodies as measured by two commercially available ELISA tests was significant in HIV positive and HIV negative patients; both tests correlated well with H. pylori detection by culture or direct microscopy. Immunoglobulin class specific immunoblots corresponded to the ELISA results in HIV negative patients but to a lesser extent in the HIV positive group which was assumed to be related to unspecific polyclonal activation in these patients. Systemic cellular immunity was investigated by proliferation assays of peripheral blood mononuclear cells (PBMC). Proliferative response to the unspecific mitogen PHA was reduced in HIV positive patients. A sonicated H. pylori antigen failed to induce lymphocyte proliferation. The antimitogenic effect was also seen in case of coincubation with PHA. This observation was independent of H. pylori and HIV infection status. We conclude that in HIV positive as in HIV negative patients active chronic gastritis is predominantly related to H. pylori infection. The prevalence of H. pylori associated gastritis in HIV positive patients is significantly reduced (p < 0.025) compared to HIV negative controls. Decreased susceptibility to H. pylori infection in HIV positive patients may not be explained by the abnormal reactivity of their humoral or cellular immune response.
幽门螺杆菌相关性胃炎在HIV阳性和HIV阴性患者中的患病率似乎有所不同。因此，可以推测其与免疫缺陷存在关联。对41例HIV阳性和47例HIV阴性患者进行了研究，这些患者因胃肠道症状接受了上消化道内镜检查，对其胃炎组织学、幽门螺杆菌感染状况以及体液和细胞免疫反应参数进行了调查。在HIV阳性患者中，37%患有活动性慢性胃炎，而HIV阴性患者中这一比例为62%。在73%的HIV阳性活动性慢性胃炎病例中，通过细菌培养和/或沃辛-斯塔里染色检测到幽门螺杆菌。在HIV阴性患者中，活动性慢性胃炎总是与幽门螺杆菌感染相关。通过两种市售酶联免疫吸附测定（ELISA）检测所测得的抗体产生在HIV阳性和HIV阴性患者中均有显著意义；两种检测方法与通过培养或直接显微镜检查检测幽门螺杆菌的结果相关性良好。免疫球蛋白类特异性免疫印迹在HIV阴性患者中与ELISA结果相符，但在HIV阳性组中相符程度较低，这被认为与这些患者的非特异性多克隆激活有关。通过外周血单个核细胞（PBMC）增殖试验研究了全身细胞免疫。HIV阳性患者对非特异性丝裂原PHA的增殖反应降低。超声处理的幽门螺杆菌抗原未能诱导淋巴细胞增殖。在与PHA共同孵育的情况下也观察到了抗丝裂原作用。这一观察结果与幽门螺杆菌和HIV感染状态无关。我们得出结论，与HIV阴性患者一样，HIV阳性患者中的活动性慢性胃炎主要与幽门螺杆菌感染有关。与HIV阴性对照组相比，HIV阳性患者中幽门螺杆菌相关性胃炎的患病率显著降低（p < 0.025）。HIV阳性患者对幽门螺杆菌感染易感性降低可能无法用其体液或细胞免疫反应的异常反应性来解释。
