Incidence and profile of Helicobacter pylori infection among HIV positive patients

Background: People having HIV infection present with a number of symptoms related to gastrointestinal tract like dyspepsia. HIV itself as well as opportunistic infections is responsible for such symptoms. Notably is Helicobacter pylori infection causes variety of such symptoms. The objective of the present research was to study incidence and profile of Helicobacter pylori among HIV positive patients.Methods: A hospital based cross sectional study was carried out over a period of two years among 101 HIV positive patients in the Department of General Medicine, Madurai Medical College, Madurai in collaboration with Department of Medical Gastroenterology and also Department of Venereology and Leporology. Rapid urease test was done. HIV status was confirmed by ELISA test. Data was analysed with the help of EPI statistical software.Results: Majority (40.6%) had CD4 count of 200-500. It has been observed that incidence of Helicobacter pylori was low in groups with low CD4 count. It was also observed that those with higher CD4 count had higher incidence of RUT positivity. This association was found to be statistically significant. The incidence of Helicobacter pylori positivity was not significantly different among those patients who were on ART (18%) and those who were not on ART (21%).Conclusions: The incidence of Helicobacter pylori infection was less in HIV positive patients. Those with CD4 cell count less than 100 had lower incidence of Helicobacter pylori infection than those with CD 4 cell count more than 500. Incidence of Helicobacter pylori infection was not affected by ART.

Evaluation of upper gastro intestinal endoscopy among HIV positive and negative patients at a tertiary care hospital: a comparative study

Background: Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. The objective of the present research was to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients.Methods: A comparative study was carried out in the department of General Medicine to study the gastrointestinal endoscopic findings among HIV positive patients and compare them with HIV negative patients for a period of two years. 101 cases who were HIV positive were compared with equal number of HIV negative subjects. The subjects in the case group as well as control group were chosen randomly.Results: There was a significant lower incidence of Helicobacter pylori positivity (38.6%) among HIV positive patients when compared to controls (73.6%). There were overall 63 patients with abnormal biopsy findings in HIV group and 75 patients with abnormal biopsy findings in the control group. Among HIV positive patients who were also RUT positive approximately 80% had abnormal histopathological findings. Similarly, among the RUT positive control 81% of the patients had abnormal biopsy findings. Incidence of normal biopsy findings was more in the control group (57.1%) compared to the study group (48.4%). But this difference was not found to be statistically significant.Conclusions: The histology of gastric mucosa was no different in Helicobacter pylori positive or negative subjects with HIV. But Helicobacter pylori incidence was significantly less in HIV positive persons compared to HIV negative.