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Ileal function in HIV infection patients: a comparison with ileal Crohn's disease.
Bjarnason I; Keating J; Smith T; Macpherson A; Posniac A; Gazzard BG;
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):440 (abstract no. PO-B19-1831). Unique

HIV infected patients with intestinal Cryptosporidiosis often have profuse diarrhoea. The pathogenesis is incompletely understood. We assessed ileal function in HIV infected patients with a dual radioisotopic test and compared the results with that obtained in patients with ileal Crohn's disease whose diarrhoea may be in part due to incomplete absorption of bile acids. Twenty healthy controls, 13 patients with ileal Crohn's disease and 7 HIV positive patients, 4 of whom had intestinal Cryptosporidiosis, underwent whole body retention measurements 7 days following ingestion of a synthetic bile acid 75SeHCAT (1 microCi) and 58CoVitB12 (0.5 microCi) with intrinsic factor. The mean (+/- SD) retention of 75SeHCAT from controls, patients with Crohn's and HIV was 38.4 +/- 10.0%, 10.3 +/- 13.4% and 27.6 +/- 22.7% and that of 58CoVitB12 60.8 +/- 16.1%, 41.3 +/- 27.7% and 25.6 +/- 22.8% respectively. All 4 patients with Cryptosporidiosis had malabsorption of 75SeHCAT and/or 58CoVitB12, to a greater extent than patients with Crohn's ileitis. HIV infected patients with Cryptosporidiosis had impaired ileal function with severe malabsorption of Vit B12 and/or SeHCAT. The former explains the frequency of Vit B12 deficiency in these patients and the latter may explain the large volume diarrhoea seen in Cryptosporidiosis.

*Crohn Disease/PHYSIOPATHOLOGY *HIV Infections/PHYSIOPATHOLOGY *Ileum/PHYSIOPATHOLOGY

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