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M9470019.TXT
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1994-07-02
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Document 0019
DOCN M9470019
TI [Gastrointestinal manifestations of HIV infection]
DT 9409
AU Schneider T; Ullrich R; Zeitz M; Abteilung fur Innere Medizin mit
Schwerpunkt Gastroenterologie,; Medizinische Klinik und Poliklinik,
Klinikum Steglitz der Freien; Universitat Berlin.
SO Z Gastroenterol. 1994 Mar;32(3):174-81. Unique Identifier : AIDSLINE
MED/94256165
AB The intestinal (in particular rectal) mucosa is the main portal of entry
for HIV in homosexual men, who represent the vast majority of
HIV-infected patients in Europe and North America. There are several
possibilities for HIV to reach the CD4-positive T cells, macrophages and
follicular-dendritic cells in the intestinal mucosa. HIV may be
transported through M-cells directly to mucosal lymph follicles.
Alternatively HIV may infect enterocytes via Fc-receptor by
antibody-bound HIV or via a CD4-independent receptor. By successive
budding on the basolateral side of the enterocytes HIV may be released
into the lamina propria. The loss and functional impairment of activated
CD4-positive lamina propria T-cells could be responsible for both the
decreased immune defense and altered structure and function of the
mucosa. The common intestinal symptoms in HIV-infected patients may be
caused by a variety of mechanisms. The high number of secondary
opportunistic or non-opportunistic infections and secondary malignancies
of the gut may be responsible for the observed symptoms. However, the
pathogenic relevance of some of these pathogens is questionable since
there is often no correlation between symptoms and presence of the
pathogen. In addition, there is a considerable percentage of symptomatic
patients without identifiable microorganisms. Yet unidentified
pathogens, small intestinal bacterial overgrowth, damage of intestinal
nerve fibres, or secretory diarrhea may contribute to the pathogenesis
of gastrointestinal symptoms. The findings of a pathogen-negative
diarrhea, of HIV-infected mononuclear cells in the gut, and of
epithelial hypoproliferation and enterocyte dysmaturation is in
agreement with the hypothesis that there is an enteropathy caused by HIV
itself.
DE AIDS-Related Opportunistic Infections/*DIAGNOSIS/IMMUNOLOGY/ PATHOLOGY
English Abstract Gastrointestinal
Diseases/*DIAGNOSIS/IMMUNOLOGY/PATHOLOGY Human HIV
Infections/*DIAGNOSIS/IMMUNOLOGY/PATHOLOGY Intestinal
Mucosa/IMMUNOLOGY/PATHOLOGY Leukocyte Count Microscopy, Electron
T-Lymphocytes/IMMUNOLOGY T4 Lymphocytes/IMMUNOLOGY JOURNAL ARTICLE
REVIEW REVIEW, TUTORIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).