RESUMO
OBJECTIVE: To determine the prevalence of Helicobacter pylori (H. pylori) infection and of various upper gastrointestinal (GI) lesions in HIV+ patients with GI symptoms and the relation of H. pylori infection to CD4 cell counts. MATERIAL AND METHODS: In all, 56 HIV+ patients and 56 age- and sex-matched HIV- controls, all with upper GI symptoms, were evaluated by an upper endoscopy examination and gastric biopsy. H. pylori status was assessed with a urease test and histology. HIV was diagnosed with the rapid test and enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of H. pylori was 50% (28/56 [95%CI 36.3-63.7]) in HIV+ subjects and 55% (31/56 [95%CI 41.5-68.7]) in HIV- controls (p = 0.57). H. pylori infection rates did not differ significantly in HIV+ patients between those with a CD4 count ≥200/mm3 (52%) and those with a CD4 count <200/mm3 (42%) (p = 0.62). The prevalence on endoscopy of specific lesions in HIV+ patients and controls were compared: esophageal candidiasis (61%, 34/56 vs. 7%; p<0.0001), esophageal ulcers (18%, 10/56 vs 2%; p = 0.01), corpus gastritis (41%; 23/56 vs 5%; p<0.0001), and duodenitis (20%, 11/56, vs 0%; p = 0.001). CONCLUSIONS: The prevalence rate of H. pylori did not differ significantly between HIV+ and HIV- subjects. Prevalence of H. pylori was also lower, although not significantly, among HIV+ patients with CD4 T-cell counts below 200/mm3. On endoscopy, esophageal candidiasis was the most common finding in HIV+ patients, discovered by dysphagia.
