Helicobacter pylori in the Era of Highly Active Antiretroviral Therapy (HAART): A Review - Abstract
Human Immunodeficiency Virus (HIV) infection predisposes to a multitude of
opportunistic infections, many of them resulting in gastrointestinal symptoms. There
were doubts about the pattern of the incidence of H.pylori in HIV infected patients: one
group argues that the immunodeficiency allows the increased replication of the bacteria
and in the other hand others argues that there is no inflammation in the stomach for the
H.pylori replication. So we aimed to find out the answer for this question, with a review
of the literature. We find that the incidence of H.pylori infection is lower among patients
with Acquired Immunodeficiency Syndrome (AIDS) compared to matched HIV-infected
and -uninfected controls. This event suggests a correlation between the improvement
of immunity as a result of more efficient antiviral therapy and the decrease in the
frequency of digestive diseases in AIDS, mainly opportunistic pathologies. H.pylori
infection and dyspepsia in HIV-infected patients have increased in the High Active
Antiretroviral Therapy (HAART) era. H.pylori infection in HIV-infected patients in the
post-HAART era has a low prevalence of the bacteria in patients with count of CD4cells
< 200/mm3
than in patients with CD4 cells count ? 200/mm3
.The knowledge of this
fact allow us to make different guidelines in dyspepsia in HIV infected patients based
on CD4 levels: above 200/ mm3
we can think in opportunistic agents and in patients
with CD4 cells count ? 200/mm3 we can think in differential diagnosis in dyspepsia
like uninfected patients. On the other hand, the managements and the protocols in the
presence of dyspepsia in HIV-infected patients or patients in which AIDS are installed
resemble the guidelines established for the general population.