Acute upper gastrointestinal bleeding in patients with AIDS: a relatively uncommon condition associated with reduced survival

Article Abstract:

Infection with the virus responsible for AIDS, namely, human immunodeficiency virus (HIV), results in a wide variety of immune system-related disorders, invariably ending in death. Many organ systems, including the gastrointestinal tract, are often the site of HIV-induced manifestations, such as malignant tumors or infection by opportunistic organisms. Although many of the gastrointestinal disorders that HIV-infected individuals are prone to might be expected to result in gastrointestinal bleeding, this is apparently an infrequent symptom in AIDS patients. To determine the true cumulative incidence of gastrointestinal bleeding, as well as the cause of such bleeding, a study was carried out involving 453 patients referred to an Italian hospital for the treatment of AIDS. Risk factors for AIDS included evidence of intravenous drug use (67.8 percent), homosexuality (22.5 percent), blood transfusion (0.9 percent), and risky heterosexual behavior (6.9 percent); the remainder (2.4 percent) had unknown risk factors. Half the patients were followed for six months or more; the maximum time a patients was studied was 42 months. Six months after diagnosis, 3 percent of the patients had developed gastrointestinal bleeding; at 14 months, 6 percent reported this complication. Survival in patients who developed gastrointestinal bleeding was significantly lower than in those who did not. In 9 of 15 patients with gastrointestinal bleeding in whom the cause of the bleeding was determined, HIV-related complications were involved; in the remainder of the patients, the bleeding was not a direct consequence of HIV infection. Hence, acute upper gastrointestinal bleeding is a relatively uncommon complication of HIV infection, but one that is associated with an unfavorable prognosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Gastrointestinal bleeding, Gastrointestinal hemorrhage

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Ultrastructure of the jejunal mucosa in human immunodeficiency virus infection

Article Abstract:

Chronic diarrhea, weight loss, and malabsorption can lead to considerable weight loss in patients with AIDS. African AIDS patients who suffer from these conditions are said to have the 'slim disease'. The genome of the AIDS virus has been demonstrated in intestinal tissue cells. However, the role of HIV in producing altered cells and clinical symptoms and illness has not been clarified. In patients with AIDS, cellular changes and signs and symptoms of disease have been attributed to malignancies, opportunistic infections, and inflammatory processes. Biopsies were taken from the jejunum (second portion of the small intestine) of 11 male, homosexual, HIV-positive patients with histories of diarrhea for more than 2 weeks. Three patients had confirmed AIDS by CDC (Centers for Disease Control) criteria, four had AIDS-related-complex (ARC), and one had generalized lymphadenopathy (swollen lymph nodes). The remaining three patients were asymptomatic except for mild, intermittent diarrhea. Examinations of the stools and tissues for acid-fast organisms, fungi, parasites and other pathogenic agents were negative. The tissue blocks of the biopsies were sectioned, coded, and examined. The microscopist was unaware of the patients' clinical histories. A variety of changes were noted in the specimens from HIV-infected patients. In the absence of any other causative agent, these microscopic tissue and cellular alterations suggest that the presence of HIV infection, itself, can produce tissue damage and the associated clinical conditions. The findings of specimens from control patients were within normal ranges. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, HIV (Viruses), HIV, Biopsy, Jejunum

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Detection of picobirnavirus in HIV-infected patients with diarrhea in Argentina

Article Abstract:

A newly described virus called picobirnavirus may be the cause of diarrhea in many HIV patients. This virus was first described in 1988. Researchers in Argentina tested fecal samples from 197 HIV-infected and non-infected patients, some of whom had diarrhea. Nine percent of the HIV-infected patients with diarrhea tested positive for the virus, but no one in the other groups did. A method of RNA extraction enhanced the detection of the virus using polyacrylamide gel electrophoresis.

Health aspects, Enteroviruses

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