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M94A2639.TXT
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1994-10-25
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Document 2639
DOCN M94A2639
TI Enteric pathogens in postmortem tissue of pediatric HIV patients.
DT 9412
AU Ramos AG; Wu TC; Saavedra JM; Bobo LD; Livingston RA; Perman JA; Yolken
RH; Dept. of Pediatrics, Johns Hopkins Hospital, Baltimore, MD.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):259 (abstract no. PB0464). Unique
Identifier : AIDSLINE ICA10/94369936
AB There is limited data on the cause of failure to thrive (FTT) and
chronic diarrhea in pediatric HIV. Previous studies on stool have failed
to demonstrate a significant pathogen in children. Autopsy studies may
provide the links to the etiology of gastrointestinal (GI) dysfunction.
OBJECTIVE: We undertook the present study to search for enteric
pathogens, specifically cytomegalovirus (CMV) and Herpes simplex virus 1
& 2 (HSV), in postmortem GI tissue of pediatric HIV patients who had FTT
or chronic diarrhea in whom microbiologic tests on stool failed to
identify a pathogen. METHODS: The immunohistochemical (IHC) technique
was employed in all samples while in situ hybridization was done in
selected cases. RESULTS: All 8 pediatric HIV patients who died at our
institution from 1986 to 1993 had GI-related symptoms prior to death.
Ages ranged from 4 1/2 mos. to 14 yrs. Enteropathogens were detected in
4/8 (50%); 2 with CMV, 1 with HSV, 1 with both CMV and HSV. All of them
had no focus of systemic infection with these pathogens. DISCUSSION AND
CONCLUSIONS: Our findings suggest that the Herpesvirus family can be
found in postmortem GI tissue of pediatric HIV patients who had chronic
diarrhea and FTT using IHC when routine methods fail to detect any
pathogen in stool. This virus may be a significant etiologic agent of GI
dysfunction in pediatric HIV. These may be the basis of future
controlled studies on the role of enteropathogens in the enteropathy of
HIV disease.
DE Adolescence AIDS-Related Opportunistic Infections/*PATHOLOGY Child
Child, Preschool Cytomegalovirus Infections/PATHOLOGY Diarrhea,
Infantile/*PATHOLOGY Failure to Thrive/*PATHOLOGY
Gastroenteritis/*PATHOLOGY Gastrointestinal System/PATHOLOGY Herpes
Simplex/PATHOLOGY Human Infant MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).