HIV enteropathy: comparative morphometry of the jejunal mucosa ofHIV infected patients resident in the United Kingdom and Uganda

Aims—To compare jejunal mucosalmorphometry in HIV infected patients resident in London and Uganda.
Patients—Twenty HIV positivepatients from London and 16 from Uganda were studied, and compared withHIV negative control subjects from both sites.
Methods—Stools and biopsy specimenswere examined for enteropathogens. Surface area to volume (S:V) ratiowas estimated morphometrically, mean crypt length of jejunal biopsyspecimens was measured, and HIV infected cells detectedimmunohistochemically were quantified.
Results—Enteric pathogens weredetected in none of the London patients, and in three Ugandan patients.S:V ratio was lower, and mean crypt length higher, in the specimens ofLondon patients than in normal subjects, but there was no difference inS:V ratio or mean crypt length between Ugandan patients and controls. A negative correlation was present between S:V ratio and mean crypt length in all biopsy specimens analysed. HIV infected cells were detected only in lamina propria.
Conclusion—Infection of cells inthe lamina propria of the jejunum with HIV stimulates crypt cellproliferation, and a fall in villous surface area. The mucosal responseto HIV is masked by other pathogens in the African environment.

Keywords:HIV; jejunum; AIDS; enteropathy